Homestead_LidenCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION FIR kP
Mate Form U-n (U / 5-M
Prescribed by ft Department of Lomil Gaenwrent Harm DEL 13 2007
INSTRUCTIONS: See reverse side for Ming instructions.
I (We) /) a J J) aJ1 /W 0 / / )a /) 1 / March, 20_
1 (We) occupied as our principal place of residence the kAlowting d xibad reld which a Ho, wiesb Tar Credit is hereby dauned:
owned 0 Are buying under contract
to�vri,
Have a beneficial interest in the entity that is liable for the p the c property and tams the property or is buying under a contract
..:-,CONTPACTRECOFtDED:*",°;�,>�,:,'i"?
If buying m ..bad, Fee SirrqAe owner's narne
Remw s office where amtradis :aoudad Pecord number Page
PROPERTY OESCRIPTIM.
OTHER COUWMSJ{,
County
Township
town, (ownsfW
County
Township
I hereby certify the above statements are true, correct and cornpiete.
of
Parcel rnmnbw
Legal description Is the property in
question:
�2*
p2ow
property ❑ Mobile Horne (LC. 61.1-7)
warty portion of the residential structure or the tanil not exceeifing one (1) acre that irrermdiately mnnxwid3 dud oucbLxe
is used tD produce income, describe the use and portion
dthe property ublimd W produce ncnne.
V
B", W
(,-dLy-,R5-1eJ1-c-700 /o?q-ORO
-�-FIRGPIYOYMED EMCLAMUOITM
OTHER COUWMSJ{,
ASSESSEDVALUE
County
Township
County
Township
I hereby certify the above statements are true, correct and cornpiete.
of
and strae4 dly; stets, ZF
C7
Valuation or $35,000
,W-11n
,12Y to /�I/'LC . O. /9
Squiture of Auclibw
A.,
ASSESSEDVALUE
,;HOWSTEADT,
�-Z.1�0,MCWAESMENTLAL
USE ONLY
OF
Valuation or $35,000
Squiture of Auclibw
Land not exceeding 1 (one) acre inwnsdialety
Date signed
V
B", W
surrounding residential improvements-
Other land
(2)
Tctal Land (fine 1 plus [no 2)
(3)
Residential wnproverients; or Annually
Dwell ng
(4)
Garage
J'A
Assessed Mobile i Manufactured Home
(5)
00w improvernents
(6)
Tctal irnlinivernents (Fro 4 dwough One 6)
(T)
Total value (line 3 ptus One 7)
(8)
I hereby car* the above is true, correct, and
cornPlew.
SqnetumafAssessa
Date signed
verifying adjon - Sowture of A41or
I
Date signed
AN ARD DEMICTHM ALLOWA N
20—Pay2O_
Lesser of 112 Homestead
Valuation or $35,000
Squiture of Auclibw
Date signed
ton FORM`!!Milli P-o TREASURER FORM T5-IA
APPROVED BY ATTE BOARD OF.AMAI ll(R.An.. PRESCRIBED BY THE DEPARTtENO(FLOCAL OOVER.YMFAT FR<ASCF ICtrl.I-LJ.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limbed to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead haul Homestead fraud causes higher tae bills for all;therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to Yerily that they are eligible to receive the
benefit and to provide additional identifying information nece.stnv to allow county government to better monitor homestead
filings.This information will be kept confidential and on only he accessed by authorized courtly officials.'fhe Department 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 Pr:werty Address
Liden, Daniel Dwayne/Katherine /64 l/-) /11;!) 51-
Marie
1 flan N Aton:n 1 Rnr
— II
566 a+o1,-no f.7666
Daniel D Liden -
P 0 Box 173 State Parcel Number Legal Description
PATOKA IN 47666-0173
26-04-25-101-000.124-020 018-00124-00 BARNES ENLG 95
IrIttIItt rIl IIrtrI(trtIIttI( Illtttitr(Ir(tt rIrr(Ir IIrrrI
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
Dan \eL l7W ay ne. • L1 ad-r1
�e Address(number end street;city,state;and ZIP eudej--- ----' --- - -- — Q-Snmeasproperty ad.'..-.os-- — - --
1V.o: x\13 \tit-\ 'C t 1M kk . 4aJo k -.0 A1(d 0 Co
Spo use First {� Middle Last
Va-c kr1P r 1 ry 1 ` 1 tt r_ L1c_e ✓n
Mailing Address(Number and street,city,stale,and ZIP code) ❑ Same as property address
p n3 \s4 t,cx m,\\5-i-, Iii- • r----Lo t1lto coca
__.
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.
Owtx Signature
A Date
PART 4:ADDITIONAL INFORMATION