Homestead_Yancey SIAlt IORM!.s'I R I Nn) IPEASUAEa FOtSI ia-IA
APPWWED BvcrMr.ar11RMIf n*'srsLm pnsiamDnY nIE oEPARME4Tw Les'e GOVERNMFNr Fn:ASCEIe I.LDl.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentne than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires Iaxpayeh who receive the homestead standard deduction to verify ttut they are eligible to receive the
benefit and to provide additional identifying information n<cesary to allow county government to better monitor homestead
filings.This information will he kept confdential and can only he accessed by authorized molly officials.The Depanntent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead thud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Yancy, Kevin M/Lana N
207 S(Main
— — I laubstadt IN 47639
6217 — -- ---_ __ _ -----____ ._ . _ -_. _ _ ____ __
Kevin M Yancey
P O Box 233 State Parcel Number Legal Description
HAUBSTADT IN 47639-0233
II III II I I II I I tt II ttt II ttt II III II 26-19-31-303-000.340-009 013-00340-00 ORIGINAL PLAN
t II III t tltr t t tt llllt t ttr I Itt 324/325/326PT/323PT
I/
PART 2: TAXPAYER INFORMATION
Owner I II // First Middle Last
6e\A n M cJ�c-e, \ yan Coy .
g Address(number and street,city,state,and ZIP code) Sane as property address — - - -
i I - I
o � � 3 aQ. -, S .�,� a/ivx Z �QA�ibs)-a/4/'I- N
Spouse Liel First Middle Last
a K c c.v 1 -e Yancc y
Mailing Address(Number and street,city,state.and ZIP code) ❑ Samespproperty address
T O S c _k 2 3 3 a 0 7 S . T'l ,n S 3- S fr-.1' -
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
° CREDIT /STANDARD DEDUCTION
j' State Form 5473 (R2 / 5-92)
1�1t CTIONS: See reverse side for filing instructions
J .Oo't" )
FORM
HC10
a
YEAR
CERTIFI N ST MENT
L�
I (We)
rtify that on the 1st day o March, 19_
1 (We) occupied as our principal pla residencQgft=tLceal
property for which a
FkWMx CIq1]is hereby claimed:
❑ I (We) owned ❑ Are buying under contract
// -
�/'
F-1 Have a beneficial interest in the entity that is liable for
the property taxes on the property ar.I That ow
.' n
r is 1- or on tract.
CONTRACT REC_P
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded
/
,,rd number Page
PROPERTY DESCRIPT1614
/^
County
Township
Taxing district (city, town, to
s p)
P rcel number
Oi3 - 00,5
Legal tlescripdon
If any portion of the residential structure or the land not exceeding one (1) acre th m ediately surrounds that structure is used lo.,lbroduce incom describe the use a portion o
the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
• re o laimant
r
.ereby certify the above statements are true, correct
and complete.
Address (number and street, city, state, ZIP code)
S..
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON-RESIDENTIAL
VALUE
VALUE
.VALUE
VALUE
Land not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Otherland
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assesor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
S
_
Valuation or $2,000
Sig r f Autlit
Date si netl
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