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Homestead_Chandler I • �t • STATE FORM 53569(R3/&10) - ' 1YFATL'Rfl f00.Ni$IA. r6 APPROVED BY STATE BOARD or AccooNTS]IDI PRFSCRIBID BY TIE DEPA0TM %,OF IM.LL GOVERNMENT FINANCE IC b1.)-'1-8.1 ' - Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes ' Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore, FILED HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the r benefit and to provide additional identifying infortimtion necessary to allow county government to bets r monitor homestead I,� filings.This information will be kept confidential and cm o111y 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. APR 5 2011 PART I: PROPERTY INFORMATION C Taxpayer Name Location Address ' Chandler, David B/Lois J _ GIBSON COUNTY AUDITOR 10512 E 1050 S LYNNVILLE IN 47619 ` 2902 I II David B/Lois J Chandler II.LIII �III�IOIII IIII_I11LIIIl�ll_In II�II II_IIIDII I_ IIDII�DIIDII_III�I III 10512E1050S Lynnville IN 47619-8802 II'II'II'ill'Illl"lIl"Ill"III'lll'llIIIl"II"'I'Illll'I'lll' State Parcel Number Legal Description . 26-20-36-300-000.870-001 PT SW 36-3-9 3.04 AC 0-19 — • • This form MUST be returned to County Auditor's office. , • Please do NOT send this form back with your tax payment to the county treasurer. r PART 2:TAXPAYER INFORMATION . • Ot. I - First Middle r Last J avid Q Cha. viae'er Mailing Address(number and street.city,state,and ZIP code) ® Same as property address . : 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 PART 4: ADDITIONAL INFORMATION • . a%^ � CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR CREDIT /STANDARD DEDUCTION HC10 State Form 5473 (R2 15-92) INSTRUCTIONS: See reverse side for filing instructions. I nNe) A �O- /-— � i1l ,�,br►�i__— Y Qp ccertify. that on't"t djy3f Nth, 19 occupied as our principal place of residence the following des ri real property-for which a Homestead Property Tax Credit is h reby claimed: ❑ I (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 p c G1 SON - CONTRACT RECORDED - - It buying on contract, Fee Simple owners name Recorders office where contract is recorded Record number Page PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County PROPERTY DESCRIPTION - County Township eby certify the above statements are true, correct and complete. Taxing district (city. town, township) . P©arcel nu ber 00 3 0 — Legal description It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of the property utilized to produce income. , Total land (line I plus line 2)) (3) o -�1 PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County Township County Township eby certify the above statements are true, correct and complete. Sig A. 3ture of cla nt A ress ( n mbera - street, city, state, ZIP code) Ll RK -W _ C,c ►5 — L4 L 1— - ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL. VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements. (1) Signature of Auditor Date si ned - Otherland (2) Total land (line 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) (6) 1 hereby certify the above is true, correct, and complete. Signature of Assessor Date signed "ryirg action - Signature of Auditor 0_ Date signed STANDARD DEDUCTION ALLOWANCE 19 —Pay 19_ Lesser of 1/2 Homestead Valuation or $2,000 S Signature of Auditor Date si ned a