Homestead_FetcherCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION Hc10
` ' ` State Form 5673 (R817 -07)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS. See reverse side for filing instructions. TT -1 if
I (We) V ce.�Ii�talo�tff�F�!'day of March, 20-
I (We) occupied as our pocipal place of residence the louring described real property for which a Homestead Property Tax iCredit is hereby claimed:
' I (We) owned ❑ Are buying under contract ova ± �TnnRR
Have a beneficial interest in the entity that is liable for the property taxes on the property and that r .pm bMeAMgbT nder a contract.
CONTRACTREc6kDE6
If buy" on contract, Fee Simple owners name
Recordees office where contract is recorded Record number Page
County I Tormship I Taxing district (city, town, township)
Parcel number I Legal description Is the property in question:
os- la- 00ia03 Ag I ❑ Real property ❑ Mobile Home (IC 6- 1.1 -7)
If arty portion of the residential structure or the}and not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
o<Ne property utilized to produce incorneo I r)
P, 6" �
ASSESSOR USE ONLY TRUETAXVALUE
ASSESSEDVALUE1
HOMESTEAD
NONmRESIDENTIAL
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
AT 100% OF TTV
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
or
43,000 for 2009 pay 2010 40,000 payable after 2012
r,' K , ✓-'a _
surrounding residential improvements.
Date signed month.day, )
Other land
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements or Annually
Dwelling
(4)
Assessed Mobile I Manufactured Home
Garage
(5)
Other improvements
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
Signature of Assessor
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day, year)
0
STANDARD .
20 Pay 20 —
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12
Homestead Valuation
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
$
or
43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of motor
Date signed month.day, )
0
ST■TE r(W5I t14.11/YMI rRFASIALA Po0.4:}IA
. APPROVED BY tr(TE WHIM OFN U.7C.2n. ptrintBm BY Mr OEPARTNEW OF LOCAL rovEBNMFBt FBi.•SrF m.-l.l:2-0.1
Gibson County Auditor
101 N Main u IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
O more beneficial,there is more incentive than eser for homestead fraud.Homestead fraud causes higher tax bills for all;therefore.
HEA 134-1-2009 requires taxpayers who receive the homestead standard deduction to verity that they are eligible to rrene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This inlomutinn will he kept confidential and can only be accessed by awhorired county officials.The Depannient 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
Fetcher, Timothy S/Patricia J
— R3 Box 167
Princeton IN 47670
_ 733 _ _ — ._._ .- - — _ - _
Timothy S Fetcher
6468 N SR 65 State Parcel Number Legal Description
HAZLETON IN 47640
26-05-12-100-003.268-017 009-03268-00 PT LOTS 1 &2 FR 12-1-10
4.00 AC C-1
X
. - PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
/ / 411dt �c 5-1_{-Fhe;.� r�f�keh-
mg Addreas(number and iB�.,. crtv,iw[e,and'Gtt•coded -____ — — — -p-Swim uv property address - —
(,>.{ G f M 5 kt 6 5 i-- C -vl^/ , - cf7 et Ufa
Spouse First Middle (� last
j--
JJ `
Mailing Address(Number and street,city,state.and ZIP code) El Same as properly address
CL et t " .u. S R L Ce C it w z eL4oci -t,&J _ (4-7& t{o
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 S�attrc Date
•
[ .