Homestead_Meny (12)11
•• ^, CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION - HC10 6
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
k(We Youpi – if that on the 1 st day of March , 19
We) ed as our principal place of res dence theme, ffoo�lowing escribed real property for which a Homestead
roperty Tax Credit is hereby claimed: -i'J I (1Ne) owned. (] Are buying under contract
Have a beneficial interest in the entity that is liable for the property.taxes on the prope 1vt t d—
property or is buying it under a contract.
_ GUN I HAG I KtGUHUtU il'r� T 1 ;L•ryO
If buying on contract. Fee Simple Owner's Name
Recorder's office where contract is recorded Record NumbePlUD .
r-murGH IT Url)LI Ir 1 IUIV
County (,Township Taxing Dis
ar & of � Legal Descri
U v
If any portion of the residential structure o the land not exceeding one (1) acre that imm diately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
. hereby certify the above statements are true, correct and
complete. '
Sig ture
Address (Street. number, city, state and ZIP code)
ASSESSOR USE ONLY - TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
.. VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Otherland
Total land - line (1) plus line (2)
Residential improvements Dwelling
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
(1)
1991 Pay 1992
19— Pay 19—
Lesser of 1/2 Homestead
(2)
Lesser of 112 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
(3)
Valuation or $1,500
Valuation or $1,500
(4)
Signature of Auditor D�Sig d (,�Jj
V ^- 7 =.v .
(5)
(6)
(7)
(8)
1 hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990
1990 Pay 1991
1991 Pay 1992
19— Pay 19—
Lesser of 1/2 Homestead
Lesser of 1/2 Homestead
Lesser of 112 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
Valuation or $2.000
Valuation or $1,500
Valuation or $1,500
Signature of Auditor D�Sig d (,�Jj
V ^- 7 =.v .
'/J
.. a It STATE FORM53569(Pi/B-lO) TREASURER FORM TS-IA
c APPROVED BY STATE BOARD OF ACCOUNTS.SW PRE SCRIBED BY TIIE DEPARTMENT OF LOCAI.GOVERNMENT FINANCE IC 6-1 1.224.1
Gibson County Auditor DIPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N.Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
Princeton,IN 47670 more beneficial,there is more incentive than ever for homestead fraud Homestead fraud causes higher tax bills for all;therefore,
FILED
HEA 1344-2009 minims taxpayers who receive the homestead standard deduction to verify that they are eligible to receive thc
ill benefit and to provide additional identifying information necessary, to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized count'officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
MAY 9 2011
° Taxpayer Name Location Address
C.'J. Meny, Margaret S
GIBBON COUNTn Y AUDITOR - 376 N RACE
IiAUBSTADT IN 47639
8320
Margaret Meny l liuillIlf[III ltI illIlFI0IIII 11111 I IIIUIli111111hi IlilII IlliihliI Milli
316 N Race St
HAUBSTADT IN 47639-8103
"IlIII11l'III'I�'II"IIIIIIIIII' 'III'IlII'l'Il'IlIllIll'IIIII'I State Parcel Number Legal Description 0
26-19-31-301-000.268-O0H/ ORIGINAL PLAN 30/31/32
•
This form MUST be returned to County Auditor's office.
Please do NOT send this term back with your tax payment to the county treasurer.
_____.,__..- PART_2: 7:AXPAYER_INFORNIAT10N_..__ _
Ov. I First Middle Last
ICI ARGAME7 5 uE /YEN)/
Mailing Address(number and street,city.state,and ZIP code) p Same as property address
3/& N fPf1cE 5r - /)AUBsTADr, /N 4'7G 37 •
S.. • Firs -- Middle I Last
Mailing Address(Number.I.: num,city,state,and ZIP code) El'Same as property s
. Social Security Number(last 5 digits) Driver ' •nse/State ED Number (last 5 digits) Other(please specify in Part 4 below
l I i I i j � 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 prerty. 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 1 Signature Date
` \
PART 4: AI)DITIONAL INFORMATION