Homestead_Heldt (5)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R418 -00)
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
I (we) )14 & J-4&4 � V-Z-W— certify that on the 1st day. of March, 20_
I (We) occupied as our principop oe'of residence the following described real property for which a Home/ Prope 'ax dit is by"61aimed:
7' ' ex d "
❑ I (We) owned ❑ Are buying under contract C, L
I '�M �A�UDITOR
GIBSON coLINITY AUDITOR
Wave 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.
N-
It buying on contract. Fee Simple owners name
Recarder's office where contract is recorded Record number Page
-M% MAWTZ; T- W
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County ZTohmstp
O� L- I'-
g ds own shi�
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Parcel number
Legal description
Cos -00o/ 7 -0;E
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If any portion of the residential structure a the land not exceeding one (1) am that immediately suffixinds that structure is used to produce income• describe the use and portion
of the property utilized to produce income.
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--TAX �
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County Township
County Township
I hereby certify the above statements are true, correct and complete.
Ir M-91 datmant
9�
(number and street city. state.
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--TAX �
lX'S—SESS ED-17AIM E'
HOMESTEAD
NONIRESIDE
Lesser of 112 Homestead
AI!U
amiii�fo
Valuation or $6,000
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Date
Land not eiceeding I (one) acre immediately
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 (fine 4 through line 6)
(7)
Total value (fine 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
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20 Pay 20
Lesser of 112 Homestead
$
Valuation or $6,000
Sig re Auditor
Date
RATE FOR5t f.11U2/'-ir TREASURER FORM TS-IA
APPROVED RV 9.V1,[KURD OFMfl*NP.`nm PREStRIDED BY TIE DEPARTMENT OF LOCAL GOVERNMENT Ft1:ACCrIcivi1-tell,
Gibson County Auditor
101 N Main 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
• 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 who receive the homestead standard deduction to verify that they are eligible to receue the
benefit and to provide additional identity-me information nec ssan'to allow county government to better monitor homestead
filings.This information will he kept conf:deruinl and can only be accessed by authorized county officials.The Depanmenl of
Local Government finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART Ic PROPERTY INFORMATION
Taxpayer Name Property Address
Heldt, Gary D/Alicia R
6103 N 525 E
Hazleton IN 47640
726
Gary D Heldt
6103 N 525 E State Parcel Number Legal Description
Hazleton IN 47640-9333
III III I I I I I I I I I I III oI I 26-05-12-100-000.017-017 009-00017-00 PT NE SE/PT LOT 3 5.50 AC
t o tot urn tit t nn ut ut t tt C-1
X
• PART 2:TAXPAYER INFORMATION
Owner I T First Middle Last
aP p oLv IA D e l o4t
�Tg Address(num Imo street_c i ty.state,a n d LlP coaey—_ -- --._ _ __ •^�oanl.as roperty adW�. _ . _ — _
co3 n( 5zS E
Spouse First Middle I�� Last
A1; via ehae
Mailing Address(Number and sweet,city,stale,and ZIP code) ^�mne as property address
PART 3:CERTIFICATION
Each undersitmed 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