Homestead_Muncy (2)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
FORM YEAR
HC10
11 It1 t ,
I (We) e 1 st day of March, 20
(We) occupied as our principal place f sidence the following describ eal property for which a Homest P.^r`operty.Tax QG9@tJs hereby claimed:
❑ I (We) owned ❑ Are buying under contract -, 1
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.
NTRACTRECORDEDT�v :T� ^�1_�Y.Fi"t"t,:z la•g.•.s�:r.E "'s1".L Ftr ,.sir,:
A .e+f x •l >�. -itil s -! r
If buying on contract, Fee Supple owner's name
Recorder's office where contract is recorded Record number Page
P. ROA, ERTYDESCRI1*T10Ne'o`yi?` }r�"'•ts
County
Tavnship
Taxing district (city, to , tow ship)
Parcel number
W
Legal description _1/
V'
Is the propertyyiiln Sue ton:
[ Real property ❑ Mobile Home (I.C. &1.1 -7)
If 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.
r.�� e { �t�t .Et3<..rsS= '��- .•!�" °__}..�.e- PROP. ERTY�OWNEDiBY .CI''.AIMANT.INiOTHER'COUNTIESr
. ��� ?i,?�"�_.?�i•�:,=!= s:'>�'.s�3•
County Township
County Township
I hereby certify the above statements are We, correct and complete.
Sign ure of ch&nt
Address (number and street, city, state, ZIP code)
valuation or 535.000
.TRUEXW'.re
:I�SE39E6NA�LUE'.
"ATF100'/e,OFi.TTV
HOMESTEAD
.,--^
Z'
.N
:+"= +-..1� . rn.a
s VALUE(
i.�, -7• «T>?3,
VALtDENTIA�Ly
s... 7.�...as ......k�S'?r+..si,e7'•
Land not exceeding 1 (one) acre immediately
�;', Y+=
;' _ - -'
surrounding residential improvements.
K
Other land
�` -
dp
::� £'•. S ?!<i?1.;:7: _ate
TUal land (line 1 plus line 2)
(3)
Dwelling
(4)
!.�
Residential Improvements or Annually
Assessed Moblie I Manufactured Home
Garage
(6)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Trial value (line 3 plus line 7)
(6)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
verifying action - Signature of Auditor
Date signed
'STANDARD DEDUCTIONIALLOWANCE .. _ .-t •, J- ��m'rn� '`. ....,.�:`_'�.r�4��v` 3;� F,�.._:i.
20 _ Pay 20 _
Lesser of 112 Homestead
$
valuation or 535.000
Signature of Audrim
Date signed
RIME FORM R3O4 I2't 4.0 TAEASULLR FORM TS-IA
VERrA'ED BY MATE WW1) AFrrrNTS.Yrn PLEAAIBED BY IMF DEPARn oa.rtru4ALC{ntLsME1.TFuascEIcLl.1-oil
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couplm arc 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 in bills for all:therefore.
III HEA 1344-200c requires taxpayers who receive the homestead standard deduction to verify that they are 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 Sr accessed by authorized county officials.The Depanment 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
Muncy, Sammy A/Neeley E
FRANCISCO IN 47649
1612
Sam Muncy
6522E 350 N
Francisco IN 47649-9275 State Parcel Number Legal Description
I I I I III 1 1 1 1 1 1 III III I I I I III 26-06-19-400-000.720-017 009-00720-00 PT SE 19-1-9 21.34 AC
111 III 1 III ll 1 II 1 1111 1 111 1 1 Ill 1 II 1 ll 1 C-1
-
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
' JAnP / >LLEAI "/ 0/kV
gAddress(number andsu t.city,sate,and ZIP code) - - - —' — 'Same as property nddnss
Spouse First Middle Last
reZ F1/4/ /2,011. ,/ /V /
C
Mailing Address(Number and street,city,slate.and ZIP code) sssi Same as propeny 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 Sig,' c Dmc
- 1111dOr SID/a ( )
PART 4:ADDITIONAL INFORMATION
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