Homestead_HubbardCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Forin 5473 (R5110-01)
raw Prescribed
by the Department of Local Government Finance,
INSTRUCTIONS: See reverse side for riling instructions.
FORM YEAR
- �HC10
A�, U 01
MAR 11 2003
I (We)
I (We) occ; as our principal la of residence the following described real property for which a Homestead'.PBj;e"T 'Z4ifit Ii claimed:
❑ I owned ❑ Are buying under contract
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.
_NTRAil;TREcoRDEo
If btritni; on contract. Fee Simple owners name
Rewrder's office whom contract is recorded Record number Page
I
Wk- MU�SEONWN -% l
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-61ESCRiO n
County )7
Township
Taxing mtrict (city, .to 7rftownship
l
j!;s (yber and street, city, state, ZIP code)
-90x AS8 /4 1 /14 7 /-1 /On. S AJ 'W -7 (14/0
as Tzpfon Is the pro on
I I- F 39=- My ❑ Mobile Home (LC, B-1.1-7)
H any portion of the residential structure or the land not xceed' (1) acre that immediately surrounds that structure is used to produce Income, describe the use and portion
of the property utilbal to produce income. ��mti , _ Z//,
5'/9 02 -5 CLIL
Wk- MU�SEONWN -% l
��-
County Township
County Tmnship
I hereby certify the above statements are true, correct and complete.
Signaturpf claim':t
j!;s (yber and street, city, state, ZIP code)
-90x AS8 /4 1 /14 7 /-1 /On. S AJ 'W -7 (14/0
Wk- MU�SEONWN -% l
��-
LEfX.i
VALUE
CSrffV
OMESTEAD -
NON9'i@T?N
I W
% T
� -
*
0yyO
Land not exceeding 1 (one) acre immediately
(1)
5 1 M
surrounding residential improvements.
-a
6- N
Other land
(2)
Total land (fine I plus line 2)
(3)
gg n
Dwelling
(4)
NO
Residential improvements
Garage
ROOM
(5)
J!gozj--
V 5-1
Other improvements
(6)
ffi 00
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 Molitor
Date signed
6ARDIDEDLIcnoW CE
RW 20 _ Pay 20 _
Lasser of 12 Homestead
Valuation or $6,000 $
Signature of Auditor Date signed
SLATE FOAM a3H1ti I AIM TREASURER FORM ta-IA
REPROVED BY STATE WARD OF.M1NTi➢An PRESESUBED UT TIM brPARTKENE Of WAL yaw"ttyMrHT FT'1\'CE M 6-I.I-L'4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead 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--30119 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to receive 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 be accessed by authorize[county officials.The Depanntenl 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
Hubbard, John E/Deborah E _
1 i Ilazleton IN 47640
7 1 /,�ynL�n'
, John E Hubbard /� '.. � L—'
' 6968 N Nixon Rd G State Parcel Number Leal Description
. ' HAZLETON IN 47640-9323
26-05-01-400-003.167-017 009-03167-00 PT SEC 1 1 10 PT LOTS 5!6
--� --li t I'tit I 'I—I t lltiI tI n I{vii I rI t"II II I I rI F I - 25.418-C-7-
— X
PART 2:TAXPAYER INFORMATION
Owner I I First 7- middle // / /1 Last
�Y7 I>n C )114-bb4 rpi
-— to Adores(number anti street,city;state,and ZiP code) - - - • Same as property address - .
9& S . d i x(5h 'Id 44 z/a-1o,, TO 4/764/0
Spouse Last
I First Middle n La
�L �bnfr ( tit, t1har�//
Mailing Address(Number and street city,state,and ZIP;code)) I r ca Same as property address
(0 2S _ _ N . -,g )(nit_ -t`r�'-- _ ia.Zr4_40r∎_ .Zu 76,v6 -- -- — - -- - -
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
unlawfull he or she ay be liab back taxes and substantial financial penalties.
Ownet i afore Date
PART 4:ADDITIONAL INFORMATION