Homestead_Teetersrt.
CLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT /STANDARD DEDUCTION HC10
State Forth 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing insiruclions.
YEAR
I (We) y l n the 1st d f March, 20_
I (We) occupied as our principal place of es ence the following described real property for which a Homestead Property Tt5�divis�e aimed:
❑ I (We) owned ❑ Are buying der contract //�� /
r 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 unmet a cenkect.
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded
Record number I Page
r.�.n. cat -r�;t i�eai' •_3, t�.,>; '� #.ROP,ERTY:�ESCRIPTIOHf.t -t".. '33'.5. -^.'' ;-" �r)rcg t^ i' '` d�yt_,s`c4°r1;`}„ds.,.i':
ny
Township
Taring district (dry, town, to p)
Pao 3
_ L do p �
(
s the pm rty in question:
on:
Real property ❑ Mobile Homo (. .8•f. 1-77
If
Of myy portion of the residential structure w the land not exceeding one (1) acre that immediately surrounds that s cture u used to produce income, describe the use and portion
property utilized to produce income.
HrYi r.�3 t y. Y ....
- _.-�r "3YtRROP.ERTYOWNEDiBY:
f '_._. -_ l ..._ ... F
CLAIMANT:
IW -_. .. -_ _... .. Y!°7.c,1 .'.. , R -4 k / -'�i�•
INOTHERCOUNTIES `s'er'._;•_r...._
County
Township
County 7avnship
hereby certify the above statements are true, correct and complete.
S' tore of a' t
Ad (nu ber and street, city, state, LP code)
C
� s °�'1°I •r rgg� `7
R USE ONOfriL; W`•
TRUETAX
"ASSESSEDMALUE
+H06lESTEAD
•s �'NONAEBt�ENTIALv s�3:
1 -4
?snrytASer�saYS
ALUEATj100%:OFT7Y,
ri < x'e.
,VALUEwwG�YALUE�
r
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
rs1i': _« _�f _g. r:
Other land
}�' 6
:Y
ri�y.N�f.�J�+''�
Total land (line I plus line 2)
(3)
Dwelling
(4)
L-r�`ce =" ';fir %S��X'Y`•s='- _.cY�" �' =;
Residential Improvements or Annually
Assessed Moab I Manufac9aed Homo
Garage
(5)
-
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, corned, and
Signature or Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20
Lesser of 1 f2 Homestead $
Vauabon or 535.000
l: STATE FORM 95M IR1l&lo) T FASLAFR F00.N TS-IA
° APPROVED BY STATE BOUDOFACCOUNTS.2100 PRESCRIBED BY TIE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC 61.E-2r-8 I
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever 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 receive the
• benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
FILED Local ove information Finn will be kept confidential infer and can onty be accessed by authorized county officials.The Department dfra of
Local Government tion1w will use this information to can onl tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Location Address
APR 06 2211 Teeters, Danny A/Teresa L
Cc �'n 2875E 700 N
•l HAZLETON IN 47640
GIBSON COUNTY AUDITOR
Danny A Teeters Il l ul l l_�II�II I�I ull�iii iii�ll.II_ II I I-�IL II IL II I�I I I II VIII_�II�II I�I�III II
2875E700N
Hazleton IN 47640-9262
11i1'1"111111111"1"11'Viii iii"II'IIII'II'II'lli'il'IIIII'lI State Parcel Number Legal Description
26-02-00-076-000.683-01y PT MD 76 1-10 1 AC 0-12 C-1
9
This form MUST be returned to County Auditor's office. -
Please do NOTsend this form back with your tax payment to the county treasurer.
t PART 2: TAXPAYER INFORMATION
O. .-..1 First Middle Last
bAANY ALBERT %SETEJe
Mailing Address(number and street,city,state,and ZIP code) - 2/Sterne as property address
Sponge First Middle _� Last
�r�scZ L y n n ,�,/ ' �/ .ee4--er5
Mailing Address(Number and street,city,state,and ZIP code) l ysame as property address
a S 7_S Qol, cl_ orb .,U. .r J . .Z�2�t1n_.aixl_ 4_7_lp- .- _ -
,
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
r 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 fmancial penalties.
owner ,tore � � . Date
PART 4: A I)DITIONA I., INFORMATION