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Homestead_Tomassetti} CLAIM FOR HOMESTEAD PROPERTY TAX FORM CREDIT /STANDARD DEDUCTION HC10 State Form 5473 (R614-03) Prescribed by the Department of Local Government Finance INSTRUCTIONS: See reverse side for filing instructions. YEAR I (We) V R certify that tha�t on th st daylni�taDcS I (We) occupied as our principal pl of residence the following described real property for which a Homestead(propel CrediL�Ls.pered❑ I (We) ow ned ❑ Are buying under contract ��Ijijll"�� hFil l. Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the properly pl,i;; buying gr qa contract. .'CONTRACTRECORDED m.`wom If buying on contract, Fee Simple owners name ./f1�iJi`� GIBSON COUNT P.UGITOR Recorders office where contract is recorded Record number Page tea` %'s't `r�us.F;�i -'e-•y n�a3.aii+ ', "1c�i*'Y'w.2""PROPERTY DESCRIPTION.[" County Toomship Address (number and sheet, ci7: st e, IP code) Taring district (city, town, township) P I r 030 .0o (�/]q�/) Leg oo � MW � I — 10 4O I ep in question: Land not exceeding 1 (one) acre immediately ✓i eat propeM ❑ Mobile Homo (LC. 6r.1 -7) If any portion of the residential structure w the land not exceeding one (1) acre that im nediatey surrounds that suttefure is used to produce income, describe the use and portion of the property ufif¢ed to produce income. surrounding residential improvements. I rM '�k _ `; E. s.. t`` �_ �,.r- .v_�...t{?5�-�.- �PROP.ERTY; OWNED )BYCL'AIMANT;IN'OTHER`COUNTIES `�,�.r;.,, -:fir County Township j County Township hereby certify the above statements are true, correct and complete. Sig tur im Address (number and sheet, ci7: st e, IP code) P .'y'!r -' ASSESSRp US,O�NY.c,Y,� c`TRUEtTAX�t >;v ASSESSED VALUE ° HOMESTEAD r N N RESIDENTIAL r.`. '•.� �YALUEs.�y zAT100 /,:OF?TV ,VALUEVALUE�`.ti,,� Land not exceeding 1 (one) acre immediately ,' ')S"r �'�? surrounding residential improvements. Other land Total land (line 1 plus line 2) (3) Dwelling (4) 'fit, ' T:,.,vs • -cv;r ss•��;.� e .Y,.,s, ,-o ax"`t Residential improvements w Annually Assessed Mobile I Manufactured Home Garage (5) _ - Other improvements (6), Total improvements (line 4 through line 6) (7) Total value (line 3 plus line 7) (6) hereby certify the above is true, correct, and Signature of Assessor Date signed complete. Verifying action - Signature of Auditor Date signed 20_Pay20_ Lesser of 112 Homestead Valueuon or 535.000 5 Signature of Auditor I I Da7rn , T -! SLATE rn0.AI,3tl ,R_t YMI TREASURER POEM 711A APPROVED1WY ANCIE BOARD OF AmnLn,a. PITSCRWw BY PIE DEPARTMENT[FLOCAL COVERNMENT'DAN'CE ICIEI.12211 Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes more beneficial,there is more incentive than e'er for homesttad fraud.Homestead fraud causes higher tax hills for all:therefore. a- l. HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to serily that they are eligible to receive the benefit and to provide additional identifying information necesiry to allow county government to better monitor homestead filings.This information will he kepi confidential and can only he accessed by authorized county officials_The Department of Local Government Finance will uw this information to create cols that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION FILE Taxpa4•h Property Address Tomassetti,Anthony Name C/Debra L No Location Description APR 1 2 Lulu Hazleton IN 47640 64 yr Anthony C Tomassetti ( ter 4-7.7 Giro Rd GIBSON COUNTY AUDITOR State Parcel Number Legal Description Hazelton IN 47640-9373 u �tt���t tr�r�rrt��t�III�t t��ttr��r�trt��rtt�� 26-02-27-100-000.361-017 009-00361-00 PT NW 2711040.232 AC itltr llII�t��trr PART 2:-TAXPAYER INFORMATION Owner I First Middle Last CA nF\nont.,1 t C_\ck:r`E, I.oYY,w.11-1 �rgAddrss(nuenberandstticet.Teitflfate.and ZiP code) - _ _ __--- .. - -- - D.-Same as propem'ai.l. - _ /23, ea ro \-x1/4-21 e io1n . -I-v-% tCU `t O - °I 3`13 Spouse First Middle Last Cb l err\ MOma.\aa.1-41 Mailing Address(Number and street.city,state.and ZIP code) Same 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,h9Jor she may be liable for back taxes and substantial financial penalties. Owner iigo uru/e �y Date PART 4:ADDITIONAL INFORMATION lir