Homestead_Renner STATE FORM 53569(R'JS-09) TREASURER FORM TS-IAI
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT Fr\ANCE 106-1.1-22-8.I
Individuals and married couples are 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
'pauses higher tax bills for all; therefore, HEA 1344-2099 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 only 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.
[ PROPERTS'1 (o7Ti5 \T10\
Taxpayer Name Property Address - State Parcel Number Legal Description:
Steven R Renner Brown ST - 26-0259-032-000.085-019 014-00085-00 BR 1ST ADD 20 PT
HAZLETON IN 47640 `X/
Complete and return to: ` ,
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART-931 '1�3' LNFORMA0 t . -
u
Owrrer.! First Middle Last
Manmg Address(number and street,city.state and ZIP code) /Same as property address -
.P6 ee,i Other(please specs y in Part 4 below)
ovc[{(vawKf.Yaa j;(ytj'oy\{r��r,\ gyp rpq
3 t-t"."
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 1 Signature - Date
•
{`lcf$ADDITIONALINFOR�IATION +
•
CLAIM FOR HOMESTEAD PROPERTY TAX FoRa1
CREDIT /STANDARD DEDUCTION HC10
State Form 5473 CRT/ 5-M
Prescribed by the Depertrrient of Loral Government Finance
INSTRUCTIONS: See /averse side
far which a Homestead PmmperCy wis hereby claimed:
pI (We) owned ❑ Me buying under conrad
I■JI Have a beneficial interest in the entity that is liable for the properly taxes m the property and that c wL tA9rtt r is under a contract
�N CODUNTY AUDITnc
' CONTRACT: RECORDED ?:. _ ,,.y. ' +'r3 �. S' '.,@ , ^ °• >.7 `.<
d buying on mntracL Fee Sinnle owrees name
fawrder's of6m where mNrad is recorded Rerad number Page
.- .: -, .... :,.. ..:.: . PROPERTY DESCRI
.
' PROPERTY OWNED BY CLAWANT MOTHER COUNTIES .+<4. 3 <f•?: +y,�. ..';ii..'.� ' , rd ".;
.r.
Township
Towr¢tsp
Taahg
�e
2 Sad street aft', sta rt's. ZIP
/ uJ . 'S r(
Legal description
Is the
in Nan:
�l J-�� ^-� �y.p�
r r 3*a3%�i +
UAW properly ❑ le Ibne (LC. 61.1 -T)
If any portion of the residential structure or the lad nal exceeding one (1) acre that irnmadralety surrounds that struciiure
is used to praduce'sxme, describe the use and portion
of the property ubkmd to prod" trlmllB.
;fiat
-.'...
' PROPERTY OWNED BY CLAWANT MOTHER COUNTIES .+<4. 3 <f•?: +y,�. ..';ii..'.� ' , rd ".;
County
Township
County
.
Tawnahip
I hereby certify the above statements are true, correct and conplete.
�e
2 Sad street aft', sta rt's. ZIP
/ uJ . 'S r(
> �, /
�l /'Hi(
ASSESSOR USE ONLY - ,
' TRUE'TAX
ASSESSED VALUE
HOlff.STEAD
�cNON�tESIDEtIMLyh+",jt'j
>ti h i RI '-
VAWE,:4
%AT 100X OF TTV�
r arVALUE.itx:fylt.IT�
C�VAUIE_`'"`+�,fl;k
Land not exDeedng 1 (one) acre Imnedately
r r 3*a3%�i +
su rounding residential improvements.
;fiat
Other land
Trial lard (lore 1 ph& Gee 2)
(3)
DareR rig
4
't trrv'it ^ 5 ''• ra'i'3
'vn
()
proveents or Annually
Residential m
Gaffe
'n• `::���
Assessed Mobile l MaGlfactured Home
(5)
N,r *��i�J.1 �� {:Y!'"d�i:.9.
Other vnpru ements
(6)
Tda1 urhprvvemerds (Ge 4 Uvough fine 6)
(T)
Trial value (lute 3 pus fine 7)
(g)
1 hereby certify the above is We, correct. and
Signatine ofASSesscr
Date signed
cornplete.
Vailyirg action - Signature of Nmmm
Dale signed
1 •• ,c`• ",o 6nVX YCLYIiIRAr riLLVAM{.0 •c:P .S! - J' : :iTl. 1 pv , ♦'i: ✓Ra4lY \i :A`?*.�.Ta'Y::.
20 _ Pay 2O _
Lesser of 12 Hortcstead
Vsivation or S35.ODO $ .
