Homestead_Bateman1 1 9
aE� 4 CLAIM FOR HOMESTEAD PROPERTY TAX — FoRM YEAR
CREDIT /STANDARD, DEDUCTION HC10 ,
State Form 54731R2 15-92)
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT DEC I U 1=0 - -
I 'We) ¢ _ c fy that on e day o r 9�t
occupied as our principal place of residence the following described real property for which a Homesa; r;Fipeb claimed:
(J I (We) owned ❑ Are buying under contract - - - %�lJ LJ1'v�'
❑ 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.
CONTRACT RECORDED-
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
"1. PROPERTY DESCRIPTION -
County
Township
Taxing district dry. town, township)
Parcel number
in - v
Legal description
/
If any portion of the residenti al swcture or the lard not exceeding one (t) acre that immediately surrods Nat structure i> used to produc mcome, describe the use and portion
of the property utilized to produce income. .
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES - -
County
Township
County
Township
®aby certify the above statements are true, correct and complete.
Si a c imam
Address (number and street. dry, state, ZIP code) Q 9a
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON-RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(t)
ate
Signature of Auditor D si ed
-
Otherland
(2)
Total land (fine I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 jobs line 7)
(g)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
" Mng tion - Signature of Auditor
Date signed
a7�0
STANDARD DEDUCTION ALLOWANCE
_ Pay 19
Lesser of 1/2 Homestead
Valuation or $2,000
ate
Signature of Auditor D si ed
STATE FORM 53569(R? -O9) - - TREASURER FORM TS-IAN
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE Ia.-Li-22-8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS'
— -Individuals and married couples are limited-to one homestead standard deduction. As the receiptofthis --
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
s andard 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
1.- Government Finance will use this information to create tools that will help county officials eliminate •
homestead fraud.
- - PARTI: P'OPER Y INFORMATION -
Taxpayer Name Property Address State Parcel Number i Legal Description:
Kenneth L/Debbie L 202 Mill 26-04-25-100-000.450-020 018-00450-00 BARNES ENLG•
--Bateman— .--
ateman.- - Patoka IN 47666 - • - - - - 101P"1789 -
I
Complete and return to:
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
- • PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
\<e..rrnve;!-k La e R a A-et\I a:r, •
Stang Address(number and street,ay,state and ZIP code) same as popaty address
P: ore:ok q2- Cb2_ ilt ice ; 1i S , Ped-sic I rJ 4)41:,‘
•
Spouse:; First Middle Last
C
i Q.11i,e 1: . k,etgh ECA zrn.an
DEIGN Address(number and street,dry:state and ZIP code)
_ . Same as poverty aatlress
Pro . t b\C Cirt- , `0 1 U--)1_ : CA s —r._ , P. 51L-r , 1 f� k4-17(066
- - 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 1 Signature Date
. PART 4:ADDITIONAL INFOR\I:a'r1ON -