Homestead_MenkeCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State FOffrl 5473 (R715-0*)
Prescribed by the Department of Local Co emmerd Finance
INSTRUCTIONS: See reverse side for filing instructions.
ov,
R YEAR
FORM
H _10 I
-i D
I (We) 1 1 \ is e certify that on the 1 st day of March, 20_
I (We) occupied as our principal ce of residence the r1gdescribed real property for which a Homestead Pro by claimed:
6
I (We) owned ❑ Are buying under contract pl�or
GIBSON COUNTY AUDITOR
Have 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
T
,coNTRAcTkmcol;to
If buying on contract Fee Simpe owner's nerni,
Recordoes dike where Contract is recorded Record number Page
PROP ERW..Oi" E66Y.JCLAIMAN T, IN -0* ER Co u WnES
ROPERT�YOESCMPTI
p 6
Camty
TaNnstup
Taft district (cily to
) 1599=07D
0
0— (nisrmlsr and street city state. Zff' code)
f/A=) IA
Parcel munber
m
Land not exceeding I (one) acre immediately
is the prcqmrtL .
!�Auestion:
tAReel property ❑ Mobile Hone, (LC 6-1.1-7)
H arry portion of the residential structure or the lieW not exceeding one (1) acre that irnm&h.(dy
surr" that shicture is used to produce income, describe the use and portion
of the property utilized to produce income.
surrounding residential improvements.
-� ME 01WROM".11104
N1t%RFP;58Vi' ji� $W' it
PROP ERW..Oi" E66Y.JCLAIMAN T, IN -0* ER Co u WnES
County
Township
County Township
I hereby certify the above statements are true, correct and complete.
Signature of daimard
0— (nisrmlsr and street city state. Zff' code)
USES kig. r
. ..........
TWRUEzTAX.�
ESSED.VALUE
14OLW
_STEAD
',e �'"KONLRESIDENTIAff,�Rr`
UA��OR
$
s
signature of kjcftw
1UE
m
Land not exceeding I (one) acre immediately
surrounding residential improvements.
-� ME 01WROM".11104
N1t%RFP;58Vi' ji� $W' it
Other land
(2)
Total Land (firm I phis Eno 2)
(3)
Dwelling
(4)
i%
Residential improvements or Annually
—15
Assessed Mobile I Manufactured Flome
Garage
(5)
Other irripmements
(6)
- WN,
"
Total improvernerds Irma 4 through fine 6)
(7)
Total value (line 3 pks Eno 7)
(8)
t
I hereby car* the above is true, correct, and
SignabsreclAssessor
Date skirted
complete.
Verifying action - Signstan, of Auditor
Dow signed
20_Pay2O_
Lesser of 12 Homestead
Valuatim or $35,000
$
s
signature of kjcftw
Date signed
ig
clog Ic*st.53 V+12'/ TREASURER rotes SIA
APPROVEOnY CTVL BARD Or ft TTR.NTS.'YN ParsWBm BY 111E DEPARTMENT frt LOLL tO\TL'MEFE M ANCE 10 t1.i::,j
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead s-indent deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ner for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
® HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verity that they are eligible to teethe the
benefit and to provide additional identifvine information necesmry to allow county gm moment to better monitor homestead
filings.this information will he kept confide mial and can only be arcs-wed by authorized county oficials-The Ikpantnnu of
Luca! Government Finance will u-c this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Menke, Etta Joyce
wcnsville RD
Haubstadt IN 47639
8291
Etta Joyce Menke
213 S 2nd St State Parcel Number Legal Description
HAUBSTADT IN 47639
26-19-31-304-000399-009 013-00599-00 E PARK ADD 358 PT/359 PT
PART 2: TAXPAYER INFORMATION
Owner 1 First Middle Last
Address(nu ter and street,city,state,and ZIP code) /r ❑ Same asproperty address '
.D . O x ( ( q 4.1 a u bt,5.-laJ - /A( ef-7 (c2 3 9
- Spouse First Middle Last
Mailing.Address(Number and street,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
seas
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is nue and correct and that he or she is eligible to
receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable-for back taxes and substantial financial-penalties.
Owner I Signature Date
PART 4:ADDITIONAL INFORMATION
•