Homestead_Bridges�. YFAR
4 CLAIM FOR HOMESTEAD PROPERTY TAX FORM IN \ -
CREDIT /STANDARD DEDUCTION HC10 6�
State Form 5473 (R5/ 10-01)
Prescribed by the Department of Local Government Finance �1 � Zf
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INSTRUCTIONS: See reverse side for riling instructions. 2[pjiJ�
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-CERTIFICATION STATEMENTI =? x,.f ���,,((' = �-s- - ?''�a °i'^'-"'? K'_a"'- at ,t �s "•:.
I (We) Tla ji j jot Le A ?e- r AT tS ce ' that on the 1 st da of March, 20
I (We) occupied as our principal place of residence the following describ real property for which a Homest d Prope T Cr t is her y med:
❑ 1 (We) owned ❑ Are buying under contract
GIBSON COUNTY AUDITOR
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.
' CONTRACT .'RECORDED7��'-- kk�fs�r.._-s_ �'- tt`r;^.'� �5
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
it ;03 t x'"" GC `a'Y- �3s '? '`,. =' Zs P. R0PERTY DESCRIPTION' v"'r�'.,• t` ° 'k `.7"E'r' y�.td>1` '£`r,<
Coon
LTL
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T_ship�
/l/�LIJ \\
Ta nship
Taxing district dry, town, township)
0
Parcel number
3 O 0
Legal description
" lot
�— �L '254
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Is the property in question:
[--]'Real property ❑ Mobile Home (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.
acre that immediately surrounds that structure is used to produce income, describe the use and portion
aG - rJ I --
Oil'
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5$ESSOR USE ONLY , „mot
3 -'''•• czse..*•$#.r:.°v� rr.
"TRUE TAX
;`�VACUE"3x`*'�
County Toxnship
County
Ta nship
I hereby certify the above statements are true, correct and complete.
Si of claimant _
Address (number and street, city, state, ZIP code)
Oil'
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5$ESSOR USE ONLY , „mot
3 -'''•• czse..*•$#.r:.°v� rr.
"TRUE TAX
;`�VACUE"3x`*'�
ASSESSED VALUE
'
ATg1OO� OFTTV
HOMESTEAD
a" VALUE
xNON= RESIDENTI,4L
,.VALUE •°
Land not exceeding 1 (one) acre immediately
t ?1,r'Y- '':+Seg °pgg•3.Y31r "`
surrounding residential improvements.
Other land
(2)N
Total land (line 1 plus line 2)
(3)
Dwelling
(4).1y,Y�,..
Residential improvements
Garage
(5)
I _ 0-S
Other improvements
(6)
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Total improvements (line 4 through line 6)
(7)
Total value (line 3 pits line 7)
(6)
1 hereby certify the above is true, corned, and
Signature ofASsessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STANDARD:DEDUCTI0 ALLOWANCE
20_Pay 20_
Lesser of 1/2 Homestead
Valuation or $6,000 $
Signature of Auditor Date signed
• STATE FORM MOP(113/61O) TREASURER FORM IS-IA
APPROVED BY STATE BOARD OF&TWSITS.ZQP PRESCRIBED BY THE DEPARTMENT OF LOCAL GOTA\MEYTFLYA`a£IC 61.13341
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.
_ HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to Verify that they are eligible to receive the r benlinegsffit fi Tanhd is to fporro m iadtie o n a ddwiiltl i obena l k epident ctiofynifindg e ninformation necessary a cto e saslelod y b y c oun
au ty o rizoernd clomuert nt oo f fibeciter
als.Thmoe n iDtoer p homestead
t
of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
MAY 102011
Taxpayer Name Location Address
C: . Bridges, Donald R/Lee A
1933E GIRO RD
GIBSON COUNTY AUDITOR HAZLETON IN 47640
137
Donald R/Lee A Bridges till DIII.OHI11101 liiiIIII 10011101011101011011]lHIII[I�111I 111:h/m/i10111110II
1933 E Giro Rd
Hazleton IN 47640-9374
IIFIIIIIIIIFIIIIIIIIEIII IIIFIIIIIIIIIIIIIFIIlI111IlIII111III lil State Parcel Number Legal Description
26-02-48-101-000.793-018/ PT LOC 101 1-10 25.80 AC
5
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.
PART 2:TA\PAYER INFORMATION
6....a l First Middle Last
tonal elo �r i" AI e5
Mailing Address(number and street.city,state,and ZIP code) 9-&The as property address , •
933 L— - Ceea R • -
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) af Same as prorYerty address
PAR1'3: 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 fmancial penalties.. (1. 1, L
rC5 .Owners:r_, alum Date