Homestead_IceN
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (RS 17 -07)
Prescribed by the Department of Loral Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
i
MAR 1 0 2009
I (We) dl.�17' AA"4~ 4.4A� *,hP4_J` certify that ol(d
I (We) occupied as our principal place of residence the following described real property for which a Homestead &M"K
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.
CONTRACTRECORDED
If buying on contract, Fee simple owners name
Recorders office where contract is recorded Record number Page
ASSESSOR USE ONLY
TRUE TAX VALUE
ASSESSE6 VALUE
PROPERTY
County
Townstup Taxing district (city, town, township)
Parcel nu -be 0��
Legal tletign'
�. 00
Is the property in question:
❑ Real property ❑ Mobile Home (IC 6-1.1 -7)
If any portion of the residential structure or the
of the property utilized to produce income.
land not exceeding one (1) acre that immediately surrounds Ural stricture is used to produce Income, describe the use and portion
^�rM
ASSESSOR USE ONLY
TRUE TAX VALUE
ASSESSE6 VALUE
HOMESTEAD
NON-RESIDENTIAL
or 43,000 for 2009 pay 2010 40,000 payable after 2012
AT 100% OF TTV
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (fare 1 plus two 2)
(3)
Dwelling
(4)
s Sr r& u v S
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
t. x ..
Other improvements
(6)
Total improvements (fine 4 through fine 6)
(7)
Total value (line 3 plus fine 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed (month, day, year)
complete.
Verifying action - Signature of motor
Date signed (month, day. year)
STANDARD DEDUCTION ALLOWANCE
20 _ pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation
$
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor c
is
Data signed (month, day, year)
Stilt i01011,3N.I RU ion 11trs azEB FORM 73-IA
.APPROVED BY Cla t aOSAD(IF AIR,It\TC.aOn PLEA-AHED BY TIE DEPARTMENT('LOCAL GOVERNMENT FINANCE IC VI.I-S}FI
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.
• HE.\ 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kepi confidential and can only be accessed by authorized county officials.The Depanment of
Local Col eminent Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
Ice, Daniel/Debra
6015 N 1000 W 1
Ilazletan IN 47640 /_fp'\f O�
106
Daniel/Debra Ice
6015 N 1000 W State Parcel Number Legal Description
Hazleton IN 47640
26-02-39-001-003.475-017 009-00109-00 PT LOC 1 1-10 6.47 AC
PART 2:TAXPAYER INFORMATION
Owner d First Middle Last
_ 9A N =fie 5c
tg Address(number Snd street,cit)C slate.aid ZIP code) —— —. - Micmac as pmp.cty'sddr. - — _.— _._ _
Spouse First Middle Last
Teo k'• AA)A) -I LE
Mailing Address(Number and street,city,state,and ZIP code) 'Ire as property 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.
•