Homestead_Byers xrx1F.FORM,'anti NMI TPFANefl ROAM 1"3-IA
wFIMPORTANT NOTICE TO HOMESTEADrP PROPERTY OWNERS
Gibson County Auditor
.101 N Main
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 ever for homestead fmud.homestead fraud causes higher tat hills for all:therefore.
HEA 1344--2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receise the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept tonfidauial and on only be accessed by authorized county officials.The Depanvlent 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
Byers, Dennis
12927 E 1025 S
OAKLAND CITY IN 47660
9331
Dennis Byers
P O Box 39 State Parcel Number Legal Description
Lynnville IN 47619-0039
III IIII I I I I IIII nn IIII I I I 26-21-32-303-701.825-001 001-01825-00 BLDG ON LSD GRND
t o nt t urn t o ut t t t t se t te Lynnville Park Lot 30
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
'Qf.NNts 0 wEv3 314£1'LS
•mg Address(number and street,city,state,and ZIP code) --- U Same as property oddness — — -- -- --
I?. 01 3ox 3q LLI JIJUtL.t IN 47(o1 9
�
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
?-o. E3 og 3G L'1 l J U\ I LLt IL) 1/441c, ;
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
unlawfidly,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date
110
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
} CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for hfing instructions
1 (We) R r I. � KA .T l� rLs v. �� i certify that on the -lst Zy bf IOla�r� 20_
Ittt- --(We) occupied as ou 'ncipal pllace of residence the following described real property for which a Homestead Property Tax Credit is hereby qqed '
(We) owned ❑ Are buying under contract
Wk Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the propeit�y)uriderac
} ix^"`•'.! CONTRACToRECORDEDM ;- 4is4,`..a'`, -,''+e
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
';� �iSTANDARDDEDUCTION`ALL'OWANCE
20 _ Pay 20 _
Lesser of 1/2 Homestead
vefueaon or 535.000
5
Signature of AudOo Date signed
b
Wt-
PROP,ERT,Y:DESCRIP.TIONti . x'' , "'�'=°`"vE`�T.T.%r- �>�''"..•;' +fir- `�u:��`
County
Township
7 district (ci , town, township)
Parcel number
Legal descdpfion Is the props in question:
Address (number and street, city, ate, LP code)
2 en- L 7" Z ' 1
!Real property ❑ Mobile Homo (LC. 61.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds drat sw re is used to produce income, describe the use and portion
of the property utilized to produce income.
- JA -.--36.3
';� �iSTANDARDDEDUCTION`ALL'OWANCE
20 _ Pay 20 _
Lesser of 1/2 Homestead
vefueaon or 535.000
5
Signature of AudOo Date signed
b
County Township
County
Township
I hereby certify the above statements are We, correct and complete.
Signatur f Claimant
•l
Address (number and street, city, ate, LP code)
2 en- L 7" Z ' 1
NNW
- •.ASSaRp!,USEONLY.F,�y/�UE.Ay
TRUE TAX
'ASSESSE VALUE
�"ATt100% "OIT,IV
HOMESTEAD•''F
�" VVALUEmVALUEf�jr
....
` Nom' ON�R fSE UENTIAL h
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
��F_'
Other land
(2)
f '' e
fae
Total land (line 1 plus line 2)
(3)
Residential improvements or Annually
Assessed Mobile / Manufactured Home
Dwelling
Garage
(4)
f 4s'.'�V:`
.�.
') rn MIA-mg y
Other improvements
(6)
r°
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
';� �iSTANDARDDEDUCTION`ALL'OWANCE
20 _ Pay 20 _
Lesser of 1/2 Homestead
vefueaon or 535.000
5
Signature of AudOo Date signed
b