Homestead_Miskell (2)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
♦ State Form 5473 (R6 14-03)
Prescribed by the Department of Local Gowemmem Finam,
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
I (We) certify that on the 1st day day of March, 20
1 (We) occupied as our rinclpal pla t e
ce of resnce the following descnbed real property for which a Homestea erty -@x pVITJ
c t' is hereby claimed:
❑ l(We)owned ❑ Are buying under contract
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the r gc%&64ng under a contract.
A
�''c`-'.«_:K.r.sv.= t:"'`•t ` 7-.- CONTRACTRECORDED _.....' .,-. ..
If buying on contract. Fee Simple ownefs name
Recorder's office where contract is recorded Record number Page
- ':;"- -P,ROP.ERTY:OWNED$Y CLAIMANTiN.OTHER'000NTIES � •+ 3 -;` -'^ °.' -_' < t -. --
PROPERTY DESCRIPTION!;: - — ".�s,• i `_
County
Township
Township
Twing district (city, town tow hi
eq
P real nyrr�p_oO , l�
l //� l ay Y
Le de 'pli
/T ('7
/OY
Is the property i
question:
eal property ❑ Mobile Homo ( /.G 6- r.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre Illat immediately surrounds that s1lucture is used to produce income, describe the use and portion
of the property utilized to produce income.
- ':;"- -P,ROP.ERTY:OWNED$Y CLAIMANTiN.OTHER'000NTIES � •+ 3 -;` -'^ °.' -_' < t -. --
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
re f dai nt
A res5 lnumber and stre7 itg st te, IP lode) T
j,�i ;s r(at ASSESSORUSE ONLY _
_TRUE TAX
ASSESSED VALUE
°
: HOMESTEAD
NON - RESIDENTIAL''
-
. ,, {F;, -,.„ s, - . =.-�; -- -
.:. VALUE
AT 100 /a OF.TTV-
_ VALUE
-,,...VALUE; "
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
.-
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
r
Assessed Mobile I Manufactured Home
Garage
(5)
-
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 puts line 7)
(6)
I hereby certify the above is true, correct, and
Signature or Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STANDARD. DEDUCTION ALLOWANCE
20 _ Pay 20 _
Lesser of 112 Homestead
valuation or 535.000
$
STATE FORM 53569(8319-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 I PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMEKT FINANCE IC6-1.1-22.8.1
IMPORTANT NOTICE TO HOMESTEAD-PROPERTY OWNERS
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
uses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
s dndard deduction to verify that they are eligible to receive the benefit and to provide additional identifying
information necessary to alldw 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.
°
PART': PROP R 1'INFORMA ION. -
Taxpayer Name Property Address State Parcel Number Leoal Description:
Mike Miskell 103 E MILL ST 26-04-24.304-000.402-020 COL DIV 78PT
PATOKA IN 47666
• 7
Complete and return to: E110M®Ofl}[00IOMODI MEMEMmH.
. .. • •, . . ..-_. GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON,IN 47670
. . PART2:_TAXPAYER INFORMATION
Owned - First Fiddle Last
'"l;c-Le I p. LIatttke t1 be, Li ay vL� . k Pt s k tit
Mailing Address(number a trees. ty. tea ZIP code) 1 Same as property address
10 3 .- as W11 ) ) PD nX 30 P to iA n i/xu.1
Last
Mailing Address(nur ter and street.city.slate and ZIP code). Sarre as property address
Social Security Hunter(last 5 digits) Drives License/State ID Number(last 5 digits) Sue Other(please specify in Part 4 below)
I
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/Signatures Date
Mi_If — nt'n
Sowse$igtahue Date Telephone 1
( )
PART 4:ADDITIONAL INFORMATION'7"-- --- -- ---- ---- .
FILE
it;
_� ( (2
GIRcON COUNTY AUDITCR