Homestead_Green (2)YEAR
CLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT/STANDARD DEDUCTION HC10
Stale Form 5473 (R51 10-01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions. rL IE D
I__114_7_ik rin_ rhl _._' " '_ , . '1'!/, .1 - -' I CERTIFICATION STATEMENT-
I (We) X, e27ht�A.Z T_ !I LZ ZeLo!r_Y� \1)12jW_Af k certify, tFat on the 1st day ) March, 20
I (We) o pied as our principal place of residence the following described real property for which a Homeslea r erty redit/ herebAait (d:
Y A
'Y AUDITOR
Zwoolowned ❑ Are buying under contract IBSO AUDITOR
aHave 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.
,'-,-_.'!V'f'& = ,CONTRACT' RECORDED M N!
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
Mal 'PROOEkTY.bESdRIOTi(jN,.�-,-'t , q;
County
Township
Wa'��
Township
axing district it. to n, township
vlo��2m
Parcel number
I hereby certify the above statements are true, correct and complete.
d
Is the property in question:
I
ress (number and street, city, stale, ZIP code)
7 El Real property ❑ Mobile Homo (I.C. 61.1 -7)
If any portion of the residential structure or the land not exceeding
one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
Land not exceeding I (one) acre immediately
'7-;;_p� "_ +z PROPERTY OWNED BY CLAIMANT IN bTHEk'CdL1NTIES
-_TRUE-TAX--,;-;
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
d
Signatu f clai
I
ress (number and street, city, stale, ZIP code)
g g%
-_TRUE-TAX--,;-;
ASSESSED VALUE
--.; �_O'
HOMESTEAD
N OWRESIDENTIAL',�—
ASSESSOR USE ONLY � �A
V ALU E'
AT,,100%_OF,TTV�,
3 f-_� VALUE%,--.
VALU E
'4""�z
Zj�i
Land not exceeding I (one) acre immediately
-4
surrounding residential improvements.
Other land
(2)
Total land (line I 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 Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
-STANDARD. DEDUCTION ALLOWANCE -
20_ Pay 2O_
Lesser of 112 Homestead
Valuation or $6,000
Signature of Auditor Date signed
St
SLATE FORM!lM IFt:/,-NI TIFASUafl FORM 711A
■flntwtn In'STAtEa AltI M M'ntLNTAbry PArHNBFT BY THE DEPAaneo- trx tCa>rtNMCAT FINANCE IC 4-11-17-1.1 e
Gibson County Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
• more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher las bills for all;therefore.
HEA 114-1-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receise the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only he accessed by authorized county officials.The Depanmenl of
Local Govemmera Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Green, Robert F/Deborah M
RI Box 96
Hazleton IN 47640
65 - - -- - - —
Robert F Green
9290 N Crawford Hill Rd State Parcel Number Legal Description
Hazleton IN 47640-9274
I1�rr��rrr�r��rrr�rr���rr r�r�rrrr�r��rrr�r�rr��r�rr��trr�rr�r� 26-02-27-100-000.650-017 009-00650-00 PT LOT 3 FR 27-1-10 2.50
K
•
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Rae Enr
- sag Address(num&er end Arnett eny.state,and ZiP code) — —_. _ _ - _ —__ .Some as ptu1r rtf uddaess
9 z90 /V, CRAvi( )sb NiL � i?D. HL fie ivl) tit. y7r'yt1
Spouse First Middle Last
�Eao2Au P1 GREEAI
Mailing Address(Number and steel.city,state.and ZIP code.) f}71 Same as propem address
?ago N• eefwfo,eo ht7Le RD tt-,
NA-Z c77A/ / ,/ t/7(a
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
44-€21 ;