Homestead_Hyneman (2)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
StEite Form 5473 (R7 / 54M
Prescribed by ft Department of Lo®i Governinerd Fn S1 6,11
177 UC770NS: See reverse side for Ming instructions. 0 iny
-A� CAM sTATENEN" 12" 4!-
I (we) I VhIIA A 041� certify that on the I at day of March,
I pied as Prinapal'pace of residence the following described real for which a Homestead Property Tax Credit is hereby chimed: d: .W-r6w) owned ❑ Are byv under contract nparly
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is bLrfing under a contract.
PROPERTY OESqWON!'..
I —elf
C104,11RACT4REC(MWk�!
Tamrihip
If buying on ..baU, Fee Simple owner's name
ASSESSOR USE ONLY
Parcel nwriber
P"al description
A in question:
piopert
_
05;z--P"
Rworder's d5ce where conrad isiootx
tarry portion of the rasiderrbd strurLtre a fhe lad nd n¢ee6rg ens (11) ace that sinxtixe
-used to produce incorne, describe the use and portion
of " properly uiif®d to prod" irio=e.
Pj3omd number
Page
PROPERTY OESqWON!'..
-'k N'% s'e,
catinty
Tamrihip
7 (CO; tow,
2
ASSESSOR USE ONLY
Parcel nwriber
P"al description
A in question:
piopert
_
05;z--P"
❑ Mobile Horne (W. 61.1 -7)
tarry portion of the rasiderrbd strurLtre a fhe lad nd n¢ee6rg ens (11) ace that sinxtixe
-used to produce incorne, describe the use and portion
of " properly uiif®d to prod" irio=e.
� I, - o (-i - 7- 5 -103- G -c3i, 0
k -,e - ` ' IN
% EMCLA�T OTHER couKr[Esq;,,.,
q�
County
Township
County
ASSESSOR USE ONLY
Township
I hereby certify the above statements are true, correct and complete.
'.':,VALUE
vatuabon W S36A0
Or(nixnber and street cd)t stater. Zfi- code)
Sign&ire of Auditor
",, 1 .,STMDAFtDDEDUCTION'ALLCr*VMCF-;,;,
'-TRUETAX
9P 44
ASSESSOR USE ONLY
VALUE'�,-
AT 100%
'.':,VALUE
vatuabon W S36A0
"N r
Sign&ire of Auditor
Mte signed
Land not exceeding 1 (one) acre immediately
sumxmding residential improvements.
(1)
Other land
(2)
Total land (Ibm I plus &w 2)
(3)
Dwelling
'Awl.
""Nov
Residential irnprovernents oi� Anniially
(4)
q,
Assessed Mobile I MantlfaCtLinsd Home
Garage
Other improvernerits;
(6)
Total improvements (fire 4 tfivough fine M
(7)
Total value (&m 3 p1w firm 7)
(8)
I hereby certify the above is true, correct, and
SWmbxe of Assessor
Date sighed
complete.
verryffig acbm - signet" of Auditor
Date signed
",, 1 .,STMDAFtDDEDUCTION'ALLCr*VMCF-;,;,
20— Pay 20—
Lesser of 12 Homestead
vatuabon W S36A0
Sign&ire of Auditor
Mte signed
Tv-
MATE FORM ',W IR'/,-N1 TRFASULLR FORM TS-IA
APPROVED DV STATE KW°OF NCYRNT62tFN !AMAMTDDY T1IE DFPARTS 4T(*LOCAL GOVaNMENi FINANCE MFIY_!.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 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 eser for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
• HEA 1341-2009 requires taspasets who receive the homestead standard deduction to verily that they am eligible to receise the
benefit and to provide additional identifying information necessary to allow county government to better mdnitor homestead
filings.This information will be kepi confidential and cm only be accessed by authorized county officials.The Depanniem of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Hyneman, John H/ Billana
Hudson RD
•toka IN 47666
626
John H/Billana Hyneman
315 S dson State Parcel Number Legal Description
Patoka I 47666-9080
�t�tt�ltllllllt a'Itttlllllllltlltllll .11 11.1.1.1..1.1 26-04-25-103-000.178-020 018-00178-00 PT NW25-1-118AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
teary /fieil t
1g Address(number and suit,city,site,and ZIP code) -- — - -- -a Santo u'pruperty uddte>.—'— —3/5" }kL ,60n &cI PcuLhc0. TL u -"WO L
Spouse First Middle Last
Pitt lrlf� urJy \Ayne.mfl n
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as pnapeny address
315 s UItildan Pate ka ,NDn ik 1f.l0
•
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
lily l 4? ,�
PART 4:ADDITIONAL INFORMATION
•