Homestead_Miller (3)o ro• CLAIM FOR HOMESTEAD PROPERTY TAX 1 FORM YEAR
CREDIT /STANDARD DEDUCTION HCio
State Form 5473 (R8 / 7 -07)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions. F e eg i � F fgyp
I (We) _ l.li -i1 W f • te> at onifi-Tstday of'March, N)_
1 (We) occupied as r principal place of residence the following described real property for ich a Homestead Property Tax is hereby claimed:
' 1 (We) owned ❑ Are buying under contract c; Sgop10� /1I(��
nJ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns Rl�properry9Ny&Yyi &ia&n3 contact.
CONTRACT • -•
!i 11 buying on comrad, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
ASSESSOR USE ONLY
TRUETAXVALUE'
ASSESSED VALUE
PROPERTY DESCRIPTION
Cou
Twmship Taring di (ity wn, t hip)
AT 100% OF TTV
el number 2 (jam
0_ 4- I-' J0 T v0
[L�e�gal /d�escripti
T` 4-
Is the pr m question:
eal property ❑ Mobile Home (IC 61.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immedetely surrounds that structure is used to produce Income, describe the use and portion
of the property utilized to produce income.
ASSESSOR USE ONLY
TRUETAXVALUE'
ASSESSED VALUE
HOMESTEAE - )
NON-RESIDENTIAL
AT 100% OF TTV
VALUE i
VALUE
Land not exceeding 1 (one) acre immediately
=i�"`" • -
surrounding residential improvements.
(1)';'-)'�v`
Other land
(2)
- ..
Total land (line 1 plus fire 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile / Manufactured Home
Garage
(5)
- .`' -::"i 's'•'r "'. -.,it -: -
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 (hereby certify the above is true, correct, and
Signature of Assessor
Date signed (month, day, year)
complete-
Verifying action - Signature of Auditor
Date signed (month, day. year)
STANDARD DEDUCTION ALLOWANCE
20 _ pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
$
Homestead Valuation
or 43,000 for 2009 pay 2010 40,000 payable after 2012
V To P-
STATE FORM l35M OTT/FIt) T1EASORIM FORM TS-IA
• APPROVED BY STATE BOARD Or ACCOUYFS.2E09 PRESCRIBED DT THE DFPARTMEST OF Ir t ooyrSR.MENr FINANCE IC 6.1.1-2.24.1
tl
Gibson County Auditor IMPORTANT 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,Mein is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
-HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify:thar they are eligible to receive the
• T benefit and to provide additional identifying information necessary to allow county gmemment ,to better monitor homestead
1 Lit filings.This information will be kept confidential and can only be accessed by authorized county officials.The Deparonent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
:ART 1: PROPERTY-INFORMATION
APR I9 201 Taxpayer Name Location Address
c. . Miller, Jonathan W/Tammy J
200 E HAUB ST
GIBSON COUNTY AUDITOR HAUBSTADT IN 47639
2753 1
Jonathan W Miller 11 11W i 111111111 II11111_Iii mmmmi_ i H ill iil]111 Ill ll101_i ii i fl I i 111m 11.1 II III
200E Haub St
HAUBSTADT IN 47639
State Parcel Number Legal Description
_-- 26-19-31-304-000.444-009/ E PARK ADD 352/3541353
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.
i� 1 PART 2: 7-AXPAYER'INFORMATION
O. . I First Middle Last
f W Mier
�o�k�wn � air, P /rl
Mailing Address(number and street,city,state,and ZIP code) Same as property address
T 664(/mot 339, 3.6,6 f SA-. \1 1r:i T 1 J 4•7(Q 39
Spouse First e"--1 Middle n Last
'.r�mrn J vC\€___ YY 1 I l er
- _. Mailing Addtess(Numbet a n d t,c i t y,state,a n d Z I P-C o d e r _- ___-..,__— ___.0-Same as property address---------- -- ,__
P o � 3321 le E. {1(—oS- u - -\-- L ti 4 7 c 35
Each undersigned certifies,wider 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 shemay be liable for back taxes and substantial financial penalties.
Owner I Signat 4' Date
PART 4: ADDITIONAL INFORMATION %.