Homestead_Meny (10)ryn CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Forth 5473 (R4I 8-00)
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10 M O3
(We) /"/tc ' V / 1— / rT�6 C • y- r 74e-,,If e J 4,— certify that on the tat day of March, 20_
I e) occupied as our pri pal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
I (We) owned El Are buying under contract
nave 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.
CONTRK 0191 CORDED If buying on contract. Fee Simple owners name
Recorders office where contract is recorded - ..Record number Page
a�3'-..�i�r F� '•��, PROPERLY% O_WNEDIB_Y;;C?A_IM_ANT'IN!OTHER
ERTjYiOESCRIP�TION a,;:,'rr�.; _' - ' —
County
Toxnship Taring district (city, , townshi J -
r� —
a ° ' 1
c ^ -
S
Parcel n be— O O / w �
0/3
Legal description
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
a�3'-..�i�r F� '•��, PROPERLY% O_WNEDIB_Y;;C?A_IM_ANT'IN!OTHER
CO_UNT_I_ES�i _::_;��•�- s °,-w� �)�; t°
County Township
County
Township
hereby certify the above statements are We, correct and complete.
Signa of claimant
ress (number and street cdry state ZIP code) L I
SSORU O �
U
fA.S.mS......,,,..cY..a•�U.E
�F..O.va M ES, ED
Ua
mE_.NuT�IT
NlONT- RssE.S..IaOSEASEM
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Land not exceeding 1 (one) acre immediately -'
esser of 12 Homestead
$
Valu on r $6,000
-
'�+,,�,
surrounding residential improvements
Date signed LG
st -;�,
Other land
(2)tca�'yn
Tdal land (fine 1 plus line 2)
(3)
Dwelling
(4)
a< : •�-'=
Residential improvements"''`
Garage
(5)fi�+,�_
Other improvements
(6)
�•� °r•`z'z
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(8)
1 hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
''•- __ STANDARUDEDl1CT10NALLOWANCE
c'm'r°ria�
`"`+,X'�Jz3fu,.•vc..:.�._
-..
qW 20 _ Pay 2O _
esser of 12 Homestead
$
Valu on r $6,000
SignatursofAuditor
Date signed LG
' •• sIAIl FIRM!a!MjR_/YHI TREASURER FORM ZU
AMU WED BY AVE MVtDUF"OMM yrw FRESIIBED BY nn DEPMnerT OF It-AL GOVTRNMEN7 FINANCE MH.1-r-,I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
•F / g �1 S more beneficial,there is more incentive wh than e'er for homestead fraud.d deduction fraud causes higher tax bills for all:therefore.
Igpl.J, t®tL'pj HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to receive the
benefit and to provide additional identifying information necessary to allow county goverment to better monitor homestead
tiling.ibis information will he kept conlidential and can only be accessed by authorized county officials.The Depanment of
L
Local Government finance will use this information to create tools that will help county officials eliminate homestead fraud.
11,U
APR 1 2 lJ PART 1: PROPERTY INFORMATION
= �6��� Taxpayer Name Property Address
Meny, George K/Theresa L 305 /3 fV jn S}-
GIBSON COUNTY AUDITOR ,q,}ctp r
Haubstadt M 47639
3088
George K Meny
305 N Main St State Parcel Number Legal Description
HAUBSTADT IN 47639-8140
26-19-31-301-000.492-009 013-00492-00 ORIGINAL PLAN 22
r n II nrIr II seer II r I t I n I n I use IIt I o flu err II nr I[l r fI r l
PT/23/24PT
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORMATION
Owner I First // Middle ��/ Last
7eO✓5e �" eOt✓1 Pico
re Address number and street,city,state,and ZIP code)),// // // Qn same as propclrty address
305 A) /�r~t�l a-f, ii,„ Waif XX) g7637
/
Spouse First Middle Last
7Zcre5K I. 36-1,1 /'ye.' y
Mailing Address(Number and street,city,state,and ZIP code) / Same as troperty address
r3oi A) 7nat,A Si //Au4,74 V763Y
_
PART 3:CERTIFICATION i •
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true 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 iguana-c A Date
PART 4: ADDITIONAL INFORMATION
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