Homestead_Wilson (8) 6
MATE FORM f5n,R_r F.Nt TAPS SLLERFOKM 79-IA
.APPR(•EO BY[rsTE BOARD O[,WTVtl%rx.Y•n PRf4Nnm Or THE DEPARTMENT OFEa:uunwrtNNrwr FINANCE ic t.1-:_1.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sandani 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.
FIFA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recebe the
benefit and to provide additional idennfyme information necessary to allow county government to better monitor homestead
I E filin)6 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 Property Address
APR 8 CU_ Wilson, Lisa A
w
401 West ST
3ON � Ilaubsudt IN 47639
S x�1
CQUNrY AUDtTog;
Lisa A Wilson
401 S West St State Parcel Number Legal Description
HAUBSTADT IN 47639-8155
26-22-01-202-000.029-009 013-00029-00 PT NE 1-4-11 383 AC
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
Owner I First Middle Last
Li s4- 4 • to it/ Son
erg Address(number and street,city,state,and ZIP code) 2 Same as property address
/
Spouse First Middle Last
Mailing Address(Number and sweet,city,state,and ZIP code) lJ Same as property address
Social Security Number(last 5 digits) Driver's 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,by claiming 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 HC10
State Form 5673 (R8 17-07) •� •• Prescribed by the Department of Loral Government Finance
INSTRUCTIONS: See reverse side for riling instructions. F IL ED
I (We) —_- /I (X.�� ( /k-- I f �� / `� certify that on the 1st day of March, 20
1 (We) occupied as our principal place of residence the following described real property for which a Homestead Pro hereby claimed,
I (We) owned ❑ Are buying under contract GIBSON COUNTY AUDITOR
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the properly or is buying under a contract.
If buying on contract. Fee Simple owner's name
Recorder's office where contract is
Record number
Page
n Tams Ip Taxing district (city, town township)
- a -o I -dba - �oo.aa
Parcel number L I d scription I Is the property question:
-.41-11 Real property ❑ Mobile Home (IC 5-1.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre That immediately surrounds that re is used b produce income, describe the use and portion
of the property utilized to produce income. 3 8 3 f1 e-
•- •
•
• .r
•
rr'. •
Land not exceeding 1 (one) arse invnediately
surrounding residential improvements. (1)
- ��_ •' -',
Other land
(2)
- -
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
.-
Assessed Mobile / Manufactured Home
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 We, correct, and
Signature of Assessor
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor
Dar signed (month, day, year)
20_pay 20_
Lesserof ill
Homestead Valuation
or
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012 $
43,000 for 2009 pay 2010 40.000 payable after 2012
Signature of motor I Date signed (month, day, year)