Homestead_Lindy1
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CLAIM FOR HOMESTEAD PROPERTY TAX
s' CREDIT /STANDARD. DEDUCTION
State Form 5473 (R215.92)
Diu
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
I (We) AAXVM certify that on the 1st day- of'March, 19
'e) upied as ou �ncrpal place o esidende the following desc ibed real prop rt for which a Homestead Prr"y 2' 01q`� 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 own the property q/is�tng under a gChtract.
_ CONTRACT RECORDED -
It buying on contract, Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County
Township
Taxing dis
-eby certify the above statements are true, correct and complete.
rptlhn r ^ O
Legal description -
If any portion of the residential structure or the and 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.
Signature of claim
t
Address (number and street, city, state, ZIP code)
6N AW? q7.1110
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 1 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 pbs line 7)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
S
Valuation or $2,000
Signature of Auditor
Date signed
I
a a • SIAIE EO M5!MIR'/tN11 T'F-YSIIIEA PORN MIA
APPROVED by MMSIL blltD OF MVrt"YTc:vv rtIYAlarrr BY THE DEPARTMENT OF LfX.SL& VER201R."r FINANCE IC 6-1.1.2Z4-I
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to ore homestead Mandard deduction.As the receipt of this deduction becomes
more beneficial,there is more incenthe than ever for homestead fraud.Homestead fraud causes higher lax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to serif).that they are eligible to Irene the
benefit and to provide additional identifying information necessary to allow county gmrmment to better monitor homestead
filings.This information will be kepi confidential and can only be accessed by authorized county officials.The Depanntent of
Local Goscnunent Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Lindy, Roy G
I lazleton IN 47640 (1019 /\
Roy Lindy -119 Li 14 5i-ate Rd (o Jr" 1 1
—` State Parcel Number Legal Description
Hazleton IN 47640-9341
lIlIIllrttltilt ttlttlllttt itltttl 11t t1tt1trt 111r1att 1tt 11t1t t1 26-06-06-200-000.925-017 009-00925-00 PT E 6-1-9 1.73 AC
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
!I 0 y G .2 / �6 %
ig Address(number and dax,city,state;and ZIP code)- - - —"' - "Some m property nddrsss — -- — —
7/ 94( ti• 5r,e77r PP.- 65 AZLtrd/1/; )t/ 97i %a
Spouse . Last
lx� First Middle L
Mailing Address(Number and street,city,state,and ZIP code) El Same as property address
X
Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sox
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 Telephone
,/i Ct - ' �----- y- 1- to
Spouse Signature Date Telephone
(( l
/
PART 4:ADDITIONAL INFORMATION