Homestead_Hyneman (4)yc cop
CLAIM FOR HOMESTEAD PROPERTY TAX F
i CREDIT /STANDARD DEDUCTION -
, State Form 5473 (132 t 5 -92) TE
INSTRUCTIONS: See reverse side for tiling instructions.
L
YEAR
�N
e)�, \1 �C�nMn.�1� `1��L.knQ�r�:4/*-' - certify that on the 1st day of March, 19�
�) occupied as ou incipal place of resideiae the following clescrib&b real property for which a Homestead Property Tax Credit is hereby claimed:
I (We) owned ❑ Are buying under contract
❑ Have 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.
CONTRACT RECORDED
ff buying on contract, Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County
TOwnShip
Taring distr
(Ty, t
n, township)
Parcel number
o0 - b aI - cD
Legal descrip'
P-1-In
It 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.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County —�
Township_- -
eby certify the above statements are true, correct and complete.
101
Signatur f Iaim
X
A m randsbeet. ary state, ZlP OOde) _
V ,
ASSESSOR USE ONLY
TRUE TAX
.VALUE
ASSESSED
VALUE..
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2,000
Signature of Auditor -
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
'
Other improvements
(6)
-
Total improvements (line 4 through line 6)
(7)
Total value (line 3 ptrs line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
ntyrttg action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1t2 Homestead
$
Valuation or $2,000
Signature of Auditor -
Date signed
CT aTE IORM,ls*la7r,wn1 memoiEA FO0.4`SIA
APPROVED BYSHTEa01POM'Aer,ensTS2on MFEVERIBR)BYTIIE DrrAane r[i LOCALCOVEaNMEBT FINANCE/C4-1.1-1:-..I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS r
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 net 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 mcehe the
benefit and to ptos'ide additional identifying information necessary to allow county government to better monitor homestead
tilima.This information will he kept confidential and can only be accessed by authorized county nl0ciuls.The Depanment of
Local Government Finance will use this information to create tools that will help county official.eliminate homestead fraud.
PART 1: PROPERTY ECFORMATION
Taxpayer Name Property Address
Hyneman, Gary L/Phyllis M
Rr I Box 168
I lazleton IN 47640
Gary L/Phyllis M Hyneman
R 1 Box 168 State Parcel Number Legal Description
Hazleton IN 47640-9334
III I III I I I I II I I I III I l i 26-05-12-100-002.721-017 009-02721-00 PT NE 12 1 10 5.00 AC
to utt fita firrrut ut nu fit t C-1
•
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
1110ng Address(nom d sumt;tit, state:arid ZIP Code) -- --- - t7 Santic as °pery address —--'- -- - - — -- -
SgQo Sase--J Qz( p � I INLk- 1ut�
Spot First t Middle Last
Lc.R S n-en-)a.in
Mailim;Address Number and street,city,state,and ZIP code) RI Same as propen address
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
•