Homestead_Simon (2) Stitt FORM!,!..111: MEASURER IORM 73-IA
.AFFMw'EO BY'Tar BOARD OF ACCOGNtz.bm ILISMBID BY nu-OFPARm a r(4 LOCAL CMcRNMrNr FINANCE IC 4-1.1-12-4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ner for homestead fraud.Homestead fraud causes higher lax bills for all:therefore.
• HEA 1344--2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying. info ntouun necessary to allow county government to better monitor homestead
lilint+.This information will be ken confidential and can only he accessed by authorised county npicisLs The Depanmern of
Local Government Finance rill we this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Simon, Marietta T
I Box 128 A
aubstabrre.-./639
8310
Marietta T Simon
703 Laurel Ct State Parcel Number Legal Description
HAUBSTADT IN 47639
26-19-31-400-000.753-009 BRIARWOOD SUB DIV II LOT 35 D-9
PART 2: TAXPAYER INFOR%IATIQN
Owner I First Middle Last
_ . �A2, E/IA -lfiloiV
og Address(number and street,city.sate,and ZIP code) - -- - - Same as property address - -- -
71 3 L n u 2 e- J ,e"61 9 c ern/ /6,fzes ii.D ri#V76
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sex
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 eligible to
receive the homestead standard deduction on this property. Each undersigned also understands that,byclaiming 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
•
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION Hcio
\ State Forth 5473 (R8I7 -07)
Prescribed by the Department oi Loral Gowemment Finance
INSTRUCTIONS: See reverse side for filing instructions. -�� T -� '�1 ��•
I(We) I 1 11AJLl9XXQ� \
certify Inatooith41s[ LV March, 2f1_
I (We) occupied as our principal place of residence the following described real property for which a Homestead P party Tax Credit is hereby claimed:
I (We) owned ❑ Are buying under contrail ��j
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is pf®�ontract.
G113SON COUN 4N
ONTRACT RECOR •
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
PROPERTY
County Tormslup Tarring district (city, lows. township)
p I Is the property in question:
m um L tlesrt� oor� sy ❑Real property ❑Mobile Home (IC 61.1 -n
If any portion of the residential structure or the land not exceeding one (1) acre that immediately rrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income. p� FV'1/`V•7rr 3S
PROPERTY
County Township
County I Irimnship
I hereby certify the above statements are true, correct and complete.
SI n re of claimant 1
ass (number and street. , city, state, and ZIP code)
ASSESSOR USE ONLY
STANDARD
pay 20 —
45,000 for 2007 pay 2008
42,000 for 2010 pay 2011
Lesser of 12
Homestead Valuation
Land not exceeding I (one) acre immediately
41,000 for 2011 pay 2012
$
-• ,: '.' -v "? `. % - _ -,
surrounding residential improvements.
(1)
-
Other land
(2)
--
Total land (line 1 plus line 2)
(3)
Y
O
Residential improvements or Annually
Dwelling
(4)
- ..
.. .
Assessed Mobile / Manufactured Home
Garage
(5)
Other improvements
(6)
Total improvements (lone 4 through fine 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 motor
Date signed (month, day. year)
___'i___________________ V.
STANDARD
pay 20 —
45,000 for 2007 pay 2008
42,000 for 2010 pay 2011
Lesser of 12
Homestead Valuation
44.000 for 2008 pay 2009
41,000 for 2011 pay 2012
$
or
43,000 for 2009 pay 2010
40,000 payable after 2012
Signature of Auditor
( d. dag
Y
O
___'i___________________ V.