Homestead_Runau RATE FORM 53569(RI/B-10) - TREASURER FORM 13-IA
APPROVED BY STATE BOARD OF ACCOUNTS.'.491 !RESLRmMD BY 111EIW7ARTMEVF OF LOCAL OOVER■SIENT FINANCE ICS-1.1-224.1
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,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore.
HEA 13442009 requires taxpayers who receive the homestead standard con to verify that they are eligible to receive the
Ir FILED benefit an d to provide additional identifying information necessary to allow county government to better monitor homes tead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Deparnnent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
MAY 5 2011 PART 1: PROPERTY INFORMATION
Taxpayer Name Location Address
C_ .ry Runau, Darrel
�V\ 105 SECOND
GIBSON COUNTY AUDITOR
SOMERVILLE IN 47683
2824
Darrell Runau
- - IIDldl11][IIIIIQ11IIIIIIIDIIII1111_[II1II_II_III111011II_-IIlII�IIIIIIII
' 5279 S Washington St
OAKLAND CITY IN 47660-7703
•
IIIi ii llillllllllIrllrlllNlllllllt'lllI'llllll iuilIItllltllI, State Parcel Number Legal Description
26-20-02-403-000.008-00S / VANADA ENLG 29
•
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.
( 1 I. PART 2:TAXPAYER INFORMATION .
°'n. . I First Middle Last
4HRe < 9e A/47/1/c-- pa ov4 cdt
Mailing Address(number and street,city.state,and ZIP code) / ` - 0 Same as property address
5 x7q S 11//951( ti.5%o� sr 9/�,0001c rty Div . 4/7,6,622
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 1 Si Date I i
.
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Fonn 5473 (115110 -01)
ur Pnscnbed by the Department of Local Government Finace
INSTRUCTIONS: See reverse side for (ling instructions.
1 r Mt�l�l
Ay
a'., ERTIFICATION 'STATEMENT'�l�'�s:s-`^°`- +5 '? :.:�i rT •�: '- ",wy`a` ',_• «s
I (We) _._._ - certi fy t the 1std/ ouMarch
(We) occupied as our principal place of residence the following described real property for which a Homestead, RgrA�QB(„'It,isher,iyd®ryed:
I (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.
NTRACT° RECORDED` '_ e - 'an'''. -x�,• n'"`111I"` ✓<d:,
If buying on contract. Fee Simple owners name
Recordefs office where contract is recorded Record number Page
_: �s��^ ����a�� '�P,ROPERTYirOWNEDBY;CLAIMANT
_ _. _ -- •.r 3Prvz rtJt �3'.
..PRUPERTYJ6ESCRIP,TIONP
County
T
ship
Taring dis (city, town, township)
Parcel number
00- --0Q
I LOW description Is the property in ues0on:
Q Real property ❑ Mobile Homo (I.C. 6- 1.1 -7) .
H any portion of the residential structure or the land not exceeding one (1) a at immediately surrounds that s1n Pchire is used to produce income, describe the use and portion
of the property urlaed to produce income.
_: �s��^ ����a�� '�P,ROPERTYirOWNEDBY;CLAIMANT
IN OTFIER' COUNTIES ".w+{-t�re��,�'�`�` =,�s` 5�`ciwls:'�i�.4
County
Toomship
County Township
hereby certify the above statements are We, correct and complete.
Signature o a t
Address ( mbeJr and sfmat, � , sfate, ZIP code)
W zzzo
qW
WIN'rA RUSE ONL�Y�
x.-g ttura:'•�s?„•= x'�VALUE•'rs'
T'RUETAX
SSiWADVALUE
AT ;100 %.OF„TTV t
HOMESTEN �'
+.tVALUE`..'_�_��rt'E=
jNON E507ENT1AL `
:YV/LL.UE i'dl
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
11)
Y }�' s r._; 431
Other land
2
()
.: A
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
�f r�44e. -r��n
Garage
i ` -
Other improvements
(6)
ZIP
`z r ;a .
Total improvements (line 4 through line 6)
(T)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is true, coned and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of /wditor
Date signed