Homestead_Tenbarge (3) 31\iE FORM!M.!IC TRFASutri FORM 73-IA
AP/ROVEnBY SITE BOARD OF ACCOU:T3.111w PAr]1(AIPFD BY 711I:OEPAkfle1-fr LOCAL GovaLmMrsT FINANCE 4-1.1-21-$.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 sundanl deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than e'er for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to creche the
benefit and to provide additional identifying information necessary to allow county govrmrnent to better monitor homestead
filings_This inlnmatinn will be Lept confidential and can only be accessed by authorized county officials.'11th Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
���� PART 1: INFORDTION
Taxpayer Name LI Property Address
_ Tenbarge, Kevin J
7 tu�u
APR
107 N Vine
Ilaubstadt IN 47639
8184 e
woe` ' AV0170R
Ke st' ueF*.7c
10 Ire• State Parcel Number Legal Description
HAUBSTADT IN 47639-8122
II ' II II I I I I II I I I II I I I III 26-19-31-301-000.533-009 013-00533-00 ORIGINAL PLAN
to Ott rut ttnuuu fit fir tat fit to \/ 120/121/147/14147114 8
PART 2:TAXPAYER INFORMATION
Owner I p First Middle Last
ece
- g Address(number and street,city state,and ZIP code) _ — -- —- - Same as property address - - — -- —---
/O 7 /✓. 1/i vE
Mailing Address(Number and street,city,stale,and ZIP code) ❑ Same as property address
Social Security Number(Ian 5 digits) Driver's License/State ID Number (last S digits) Other(please specify in Part 4 below)
Sate
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,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date Telephone
Spouse Signature Date Telephone r l
PART 4:ADDITIONAL INFORMATION
•
a °� f CLAIM FOR HOMESTEAD PROPERTY TAX
s� CREDIT /STANDARD DEDUCTION
; State Form 5473 (R2 15-92)
INSTRUCTIONS: See reverse side for tiling instructions.
�L ORWA IR YEAR
J1.F
H
nnI 9 ^010 3
W
I (We) - � f / - certify that on the 1st day of March. 19
I (We) occupied as our pri pal place esidence the following described real prop y for which a Homestead Property Tax Credit is hereby claimed:
l(We)owned ❑ Are buying under contract
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.
CONTRACT RECORDED -
If buying on contract, Fee Simple owner's name, -
Recorder's office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION -
County
Township
Township
Taxing district cit . 1own, ro nship)
Parcel number
Legal descr lion
013- 00533' -00
Otherland
7�
It any portion of the residential structure or the land t e ceeding 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
-
�
Total land (line I plus line 2)
(3)
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
r1heleby ty
Township
County
Township
certify the above statements are true, correct and complete-
Z-q—na-tum of clai an
r (number and street. rats, state, ZIP code)
49 ST
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or S2,000
-
-
Otherland
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pUs line Z)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
tying action - Signature of Auditor
L
Date signed
- STANDARD DEDUCTION ALLOWANCE
19 Pay 19 _
Lesser of 1/2 Homestead
S
Valuation or S2,000
Signature of Auditor
Date sign