Homestead_Bammer0 CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
0, State Form 5473 (R6I403)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for Ming instmclions.
certify that on the 1 st day of March, 20_
I (We) pied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ I (We) owned ❑ Are buying under contract
No Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
z
ctzs �.'S>z+v:' °Fr a-- v'r�`.1ir`- i ;.-•' �, a.s'P'i -'.=`� CONTRACT.= RECORDED,hµ','i
If buying on contract, Fee Simple owner's name U
Recorders ofioe where contract is recorded Record,numbei �' Page
P,ROP.ERT.Y.DESCRIPTION^'r,?r
County
Tovnship
County Twvnshi P
Tarng district (city, to o ip
PV
— oa 3Sa-a
Leg In
i^
Is the Pro i u�
/r
osdon:
p perty ❑ Mobile Homo (I.C. 6-1.1 -7)
If any portion of the residential structure or the land not exceeding one (1)
of the property utilized to produce income.
ace that im ilta t� cis that structure is used to produce income, describe the use and portion
'!
' 'C - o Al- 3�
- 06a.3
L
r:~ 3 t
County
Township
County Twvnshi P
hereby certify the above statements are We, correct and complete.
gn o nt
$
dre umbe nd go 20, ZIP code)
Q 0- f� I
70(f oiv'?Al r1 41b
L
r:~ 3 t
1V----
TAX
Eiry
OF
100 %TTV
y
ESAF
: MVALUE
sNEDENASSSSORUSEONLY1
VASLUE AASSESSEDAL%
Land not exceeding 1 (one) acre immediately
$
Signature o -
r _
surrounding residential improvements.
Otherland
(2)`�'
�4`;
Trial land (line 1 plus line 2)
(3)
,
Dwelling
(4)
ss�
W,.�:�1yy}i..'Y.r'�r.a
Residential improvements or Annually
Assessed Mobile / Manufactured Home
Garage
(5)p�is`k
�.�3��maifaef
Other improvements
(5)
_ ,t <. � - I
,,..;
Trial improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is We, coned, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
9STANDARD`DEDUCTIONIALGOWAHCEt
20 _ Pay 20
Lesser of 112 Homestead
Vauaoon or .000
$
Signature o -
DateMReq ^
lJ —0 —O J`
slAtE FfR\IT3!M1R:r f,Ml TRFAS1jj[A FORM a-IA
Arrww'En BY STV[N■RDIN ArVYRNrs.'0. PP/SCRIBED BY TIE DEPART '4T OF LOCAL r vt 'NEFr FINANCE IC 64.144.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and =flied couples are limited to one homesead sundae]deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud Homestead fraud causes higher tat bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are elicible to reeehe the
benefit and to provide additional identifyine information necessary to allow county government to better monitor homestead
filings.This infarnutinn will he kept confidential and ran only he accessed by authorized county officials.The Depanment 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
_ Bammer, Joe/Pam
RI
PATOKA IN 47666
442
Joe Bammer
2300 W 350 N State Parcel Number Legal Description
PATOKA IN 47666-9086
Ii�ti�int�tilitilliit lln�illl �nilulitlln llririlinln ll�- -- -- 26-04-23-304-002.352-018 PT SE SW 231112.56 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
SO SE?t- R1 A1AL '3RmmSg.
�g Address(number and street.city,state,and ZIP code) -- `i Same Is property address ---
Spouse First Middle Last
'?Prm ,p- Ci LL ` emmca2
Mailing Address(Number and street,city,state.and ZIP code) ® Same as properly 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 Si Date
PART 4:ADDITIONAL INFORMATION .