Homestead_Mayer (7)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDITISTANDARD DEDUCTION HC10
q ` State Form $473 (R4 / &00) 1:
INSTRUCTIONS: See reverse side for filing instructions. rILEu
I (VJe) �Yt /l / ) /(i(sY /IX/l�� s certify that on the 1st ay of Larch, 20 /t
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I (We) occupied as our principal place of residence ttie toll described real property for which a Homestead Properry'Tac Credits hereby- jahned:
❑ I (We) owned ❑ Are buying under contract ° r'CITOR
'01ave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
Itb owners name f��CONTRAGTaRECORDED'� `''�`'i. ".r. •a���: ��i.-^�'.�� 'e
If buying on contract Fee Simple owners name - _
Recorders office where contract is recorded Record number Page
- � -��
YCounty
�; • - 4,� , � FROPERTjY�D_ESCR.IPYTION'—
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County Township
Township Taring district (city; town township)
F P I r
Legal description
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If any portion of the residential structure or the land not exceeding one (1) am that imme iat s mounds that structure is used to produce Income, describe the use and portion
of the property utilized to produce income. - -
P PROPS_ RT_ Y!OWN_EDtB
M_ NT IN 0-- _- NCO_UNTIESr_r-t�..- -3' e ,ueS N WSIM
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County Township
County
Township
I hereby certify the above statements are We, correct and complete.
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'� s (number an f. ciAt state, !P ) 1
20_Pay 20_
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QSSESSORUSE'ONLY 1t! nt"
".r3 �i••Tst° -_'�' '.flL' °c n,'3r�NIS
UE A C �
k 5 �, -:� a "
ASSESSED VALUE
s -
r�s�AT1,. +°/a?�F
�'r4S,kiOMESTEA�
�:i�nUE .
-" +�.,�.,E rE...,r
NON-RESIDENT1AL.h-
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Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)'•3
Date signed
'I'..��aarr..--
Otherland
(2)'
=`?`
Total land (line t plus fine 2)
(3)
Residential improvements
Dwelling
(4)
"
.-r y� -•"`"� -
Gara ear
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Other improvements
(6)
'p`��,'^=
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(S)
1 hereby certify the above is We, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
20_Pay 20_
��•,*-;,y. -�-
Lesser of 12 Homestead
$
Valuation or $6,000
Signature ofAuditor
Date signed
STATE MRS'MM<nur 9µ1 •TITASI ll HAM 73-IA
APYRP'EO BY MATE KARnrM MTh ITt.:Wx PILIFSOUBM BY nit DEPARTMENT Or LOCAL roxttN•FWT FINANCE Ms1.1-ral
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple. are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is mole incentive than escr for homestead fraud_Homestead fraud causes higher tax bills for all:therefore.
is
HEA 134 4-2IX9 requires taxi-axe's who receive the homestead standard deduction to verify that they are eligible to reaene the
benefit and to provide additional identifvinc information nece,arn to allow county government to better monitor homestead
tiling,.This information will be kept canlidemial and can only he accessed by authnrbed county officials_The Depanntent of
Local Government Finance will use this information to create molt that will help county official,eliminate homestead Baud.
PART 1:PROPERTY INFORMATION
Taxpayer Name Property Address
_ Mayer, Scott
RI lox 1005
Haubstadt IN 47639
7378 - - - - - -- - - - -- -
Scott Mayer
1004 David Ct State Parcel Number Leeal Description
Haubstadt IN 47639-8167
1t1tt 11trtE11tttt11t1tIt tlt t1tttt 11r11tt1tt t111rtttltrltlt�tl 26-188--36-403-000.688-009 013-00688-00 WEST HGTS 4TH ADD 20
I
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
SCoTr- Z--- 144yew
-- ig Address(number and street,city,state,and ZIP code) - -- -- --- 2 Same as property address - - - --" " - -
/oo'{ Del-0th ems. HRv(3st o-r- :zit) 9 7039
Spouse First Middle j Last
J G-�A1 „✓F� � f-f yt/G.--
Mailing Address(Number and street,city,state,and ZIP code) 2Same as property address
/o5 `l 1D,4v 1 b C r II 406 1/45729-67- SN Cf 7G 3 ?
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury•,that the above and foregoing information is true and correct and that he or she is elieible to
receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfillly. or she may be liable for back taxes and substantial financial penalties.
(Tuner' S urc Date
PART 4:ADDITIONAL INFORMATION