Homestead_Backes4
CLAIM FOR HOMESTEAD PROPERTY I L E FORM YES
STANDARD / SUPPLEMENTAL DEDUCTION
State Form 5473(R12 I& W) HC10
Prescribed b the Department of Local Government Finance AUG A U 4 L U l U
•� ,.0 ? Y may,,
INSTRUCTIONS: See reverse side for fling instructions. O'f
y`�
'r
I (We) it certify that I (we occupied as my (our) principal
place of reside4cif or am (are) buying the folio mg describe real property for which a Homestead Property lax Stand ctir"t�' tereby claimed
,.under contract on the date this application is filed, (date of filing): GIB$ON COUNTY AUblzFfjji
�Cl 1 (We) own ❑ Am (are) buying under recorded contract
Am (are) entitled to occupy as a tenant - stockholder of a cooperative housing corporation
❑ Have a beneficial interest in the trust or the right to occupy the property under the terns of a qualified personal residence trust
INFORMATION
Name of da' I name)
Social Security number of claimant (last fine dgds)
Drivels license I
Social Seciit
��
��
of claimant's spouse (last Eva dlgitt)
CONTRACT RECORDED
If buying on corded, Fee Simple owner's name
Recerdels office where contract is recorded Record number Page
PROPERTY DESCRIPTION
Cmn Township Taring dis 'd ( , town, townshi
( /,'•
Parcel number
L al desaiti
s the eery in question:
Real property ❑ Annually assessed mobile home (IC 6-1.1 -7)
If an of the residential strucwre or the land not exceeding one (1) ace that irtvned surtou�s Nat swarre is used w produce income, describe the use and portion
If N petty utirnzed N produce income.
%9_ ova _40616,
PROPERTY. OWNED BY
County Township
County Township
I hereby certify the above statements are true, correct and complete.
Signawre t ;
Pddrew1numbe�nd st2at, qty state, and z�rxrda) t I - ^ I n \ 1 4 b
•2�JJrr IV
��jj .ISO
�l
--�\'' 1 ry AQ �rJ !
r HOMESTEAD NON-RESIDENTIA
ONLY AT 100% OF TTV I VALUE VALUE
Land not exceeding t (one) acre immediately `*Nx``,+'j
(t)
suroundin residential improvements. x�'= �s'"'''<S -�•- -. r3
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Yi`), 1'.- v,.`. -i ✓{t'r��.lS
Residential Improvements or Annually
-x+�'' - 'ai�-�.T r Nt
Gare a'i?ig'y.-"k
9
(5)
s'•.t
..-�+'.I�,Hr`•`$;�;
Assessed Mobile 1 Manufactured Home
Other improvements
(6)
Total Improvements (line 0 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is we, cored,
Signawre of Assessor
Data signed (muriM, day, year)
and complete.
Verifying action - Signawre of Auditor
Date signed (month, day. year)
' STANDARD DEDUCTION
20 _ pay 20 Lesser of 60% of the assessed value of the homestead or $45,000
Notwithstanding any other provision, the sum of the deductions provided in IC 6.1.1 -12 to a mob ➢e home that is
$
nor assessed as real property or to a manufactured home that is not assessed as real property may net exceed
-
aie- hall (142) of the assessed value of the mobile home or manufactured home.
Signawre of Auditor
Dale signed (month. day, year)
y`�
• a STATE FORM 53%4 ER)/&la) IRAMA..,FO0.HISIA
APPROrTD BY STATE BOARD Of ACCOUNTS.ATP PRESCRIBED BY THE OFYAR3MET OF EXCAI.GOVERNMENT FINANCE ICa-I I-228.1
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 in bills for all;therefore,
tri FILED 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
filings.This information will be kept confidential and can onty be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
MAY 6 2011 PART 1: PROPERTY INFORMATION
Taxpayer Name Location Address
Backes, Michael G/Nancy K
GIBSON COUNTY AUDITOR 303 MILL
HAZLETON IN 47640
230 1
Michael G Backes III[IIH IIDII IDI! III I�IIID�IIDIIII�I�I�ILIII Ill III01_IIII _II_DII�IIIIDII I� III
303 S Mill St
HAZLETON IN 47640-9020
"I'iII""IIIIIIIIiiII'iIFIiIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII State Parcel Number Legal Description
26-02-59-032-000.036-019 /BR 1ST ADD 14 PT
a
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
"'7: TAXPAYER INFORMAL ION _ __ _ _ .. -
Ow__r Ir First - Middle Last
/ e A d e/ GAR 6e- bac,te s
Mailing Address(number and street,city.state,and ZIP code) 0 Same as property address
,..
Spouse First Middle Last
Niwev Kw ?3ac Kes
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,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date
PART 4: ADDITIONAL INFORMATION