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Homestead_Wilson a STATE FORM 51550 IR3/8-10) TEASURFA FOLM TS-IA APPROVED BY STATEBOARB OFMtOUNS,X09 PRESLFIB19 BY TIE DE➢ARME\r OF LOCALc0VEm'NEVr FINANCE IC6-1.1.214.1 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 1344-2009 requires taxpayers afro receive the homestead standard deduction to verify that they are eligible to receive the 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 county officials.The Department of Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. . PART 1: PROPERTY INFORMATION _ . Taxpayer Name Location Address _ Wilson, Daniel W/Sharmin H - 104 S JEREMY LANE HAUBSTADT IN 47639 2348 Daniel W/Sharmin H Wilson . I II IIIII DIII III IIIIIII�II.�IIIILMilli 11911]11 III011 I III II III011�1101 I II ® S Jeremy Ln FILED•] Haubstadt IN 47639 H A 1-1 1 1 E 1lLJ/ State Parcel Number Legal Description 26-18-36-403-000.569-009✓`NEST HGTS 3RD ADD 204 _JUN_0 2 2011 ___ __ - _ c. .M y GIBSON COUNTY AUDITOR 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. - ',;' 'PART 2: TAXPAYER INFORMATION O. . I - First Middle - Last Mailing Address(number and street,city,pate',and ZIP code) Same as property address l a y S r e E t jape 1th4.S-�-di Id /77693Y First Middle ' , / Last _�h� rn� -1 Il ' I © M�1 Ity _ _ ° �/9-g 6-Oa l-4 e r cm_ (v 1-a n e 6.6 - d -- — ( 3 9 --_- 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 e unlawfully,he or she may be liable for back taxes and substantial financial penalties. Owner I Signature Date • iCLAIM FOR HOMESTEAD PROPERTY TAX CREDIT /STANDARD DEDUCTION State Fonn 5473 (R2 15-92) INSTRUCTIONS: See reverse side for (ling instructions. FORM HC10 YEAR CERTIFICATION STATEMENT lip, certify h std a e) as our principal place of residence the following described real property for which a Homestead P rty ax redii i he�eb ai d: (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 A o g LU contract. CONTRACT RECORDED / It buying on contract, Fee Simple owners name ON COUNTY AUDITOR. Recorders office where contract is recorded Record number Page PROPERTY DESCRIPTION County Township Taxing district 0 ". township) O Legal description M M number �Q If any portion of the residential structure or the land not exceeding one (1) acre that immedia surrounds that structure is used to produce'uxrome, describe the use and portion of the property utilized to produce income. PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES County !Township .ereby certify the above statements are true, correct and complete. S azure of t tldress (number and street, city, state- ZIP code) . C \1 W a ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON- RESIDENTIAL VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements. (1) 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 plus line 7) (8) 1 hereby certify the above is true, Correct, and complete. Signature of Assesor —rate Date signed Ventying action - Signature of Auditor STANDARD DEDUCTION ALLOWANCE 19_ Pay 19 Lesser of 1/2 Homestead Valuation or $2,000 S Signature of Auditor Date signed