Homestead_Estes CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
tk.— 1; STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R15/5-14) HC1 D
- Prescnbed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers am confidenti-!un.-r; 6- 1-12-3 I 'L
• -- r+boj - -n.-^rfa- - cm “CER11FIC-A.11OO":TATEMENT? - �r-' ') r ^r •t :v r'-
I(We) f ri1.1CWrl.•LIC'� certify that I(we)occupied'as my(o principal
place of residence or am(are)buying the following described real property under contract for which a Homestead rPro rty T x Sndard
Deduction is hereby claimed on the date this application is signed, _ (date cryggpi3t). I
❑ Own. ❑ Am(are)buying under recorded contract.
D Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualifie trust
❑ Am (are)the shareholder, partner, or member of the entity that owns the property. GIBSON COUNTY AUDITO
t
`� _
If baying on contract,Fee Simple owner's name
Recorders office where contract is recorded Record number Page
.:s RL"._..3v—
�c?:.r 71-47-15't-et PROPERTY:DESCRIP110 Pat-_ `-ath-7 4,. =
`:-74E33 l
Co 9 Township Tai ( 1lm,tow tip)`�41 • r
Pnarcel number Legal description Is the property in question:
a(41-b4-M4abcob,a3'4-OIa 0 Real property ❑ Annually assessed mobile home(/C 6-1_1-7)
It any porton of the residential st Gore or the land not exceeding one(1)acre that-immediately surrounds that strcure is used to produce income,despite the use and portion
of the property utilized to produce income.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sate.County,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
Signature ant ,i, -�
I hereby certify the above statements are true,correct,and complete_ I •
Address of conga(number and street.ay,state,and ZIP co/de) Address of vacated homestead,d any(number and street,ply,state,and ZIP code)
� 'le 2D N200 -la /Al It 464
Land not exceeding one(1)acre immediately I(1)
surrounding residential improvements
Other land 1(2)
Total land(line 1 plus line 2) 1(3)
Residential improvements or Dwelling I(4)
Annually Assessed Mobile I
Manufactured Home Garage I(5) I
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct, I Signature of Assessor Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
= .. a- - --'4++ _..3,..._=°STANDARD DEOUCTIONALLOWANCE*1- 3 -a=--#.t._x€�`�-t•,„�; WZ--,_
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000
Notwithstanding any other prevision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed one-half(12)of the assessed value of the mobile home or manufactured home.
Signal•1-of• •tor • Date signed(month,day,year)
'ta.il I ♦ _ 11.4114/11 k S
il
DISTRIBUTION: Original-Couny Auditor,Fie-Stamped Copy-Taxpayer
0
suds FORM OHICt irnl 'MANUA W0.V SIA
APPWWEO BY RVEMNPD Or MYYUSR.9D PIUSRSIFD BY nIC DEPARnrnT OF LIXAL OAVELNMEFT FINANCE re 41-1.1-r-4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
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 e'er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-200O requires taxpasers who receive the homestead standard deduction to verify that they an eligible to receive the
benefit and to provide additional identifying information rusary to allow count-government to better monitor homestead
filint,S.lltis information will be kept confidential and can only he accessed by authorized county officials The Ikpanment of
Local Government Finance will use this infoLFnation to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Estes, Randall M (ryf!L
Cunningham Ferry Roltl
Patoka IN 47666
393
Randall M Estes
4820 N 200 W State Parcel Number Legal Description
Patoka IN 47666-9040
' I I I III I I I I I I I I I II I I I I I I I I 26-04-14-400-000.234-018 010-00234-00 PT SE 14-1-11 9.60 AC
t o tot to nt te t u tut n use te
1<
PART 2:TAXPAYER INFORMATION
Owner I First Middle _ Last
RA AHA
� if flAA+koN E 5Fes
ag Addr¢s(number and i¢cet,city,suite,-and ZIP-code)_ _ —_ _
) J fntc'm properly address-- _ — - -
45a0 lb/ boo u3 PA- -0ka , L■ 47bb6
Spouse First Middle Last
CON NIe .3-DAN 5te5
Mailing Address(Number and street,city,stale.and ZIP code) Deane as properly address
42ao /j. aoo lto. pm-foIC4, 1)J N7666
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 INFOILMATION
FORM MC 10 1979 To Be Filed in Duplicate
Hescribed By State Board of lax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR lg(Y,
SEE BACK FOR FILING INSTRUCTIONS
�(We) �n �� � -� �!dQ- 44J certify that on the 1st day of
Aarch, 19--�i-'O I, (Wej occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial interest in the
Property Description ins -C
Taxing District (City, Town, Township):
Parcel Number or
0/b -VoOq
i
Township
description shown on tax statement:
If buying on contract: Owners name i1PP5inp1e..neflC:;n0 —�/i �`�- j!DQ -
3 S�- 0/S
Contract recorded in Recorders Office - Record No. Page If 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
Any other counties in which individual owns or is buying real property:
I hereby certify the above statement is true, correct and complete.
0
'Signature
Street Address
County Township
City. State and Zip Cone
Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other Land
Total Land
Residential Improvements Dwelling
Garage
Total
Other Improvements
Total. Improvements - Line (6) plus (7) equals (8)
IWy certify the above is true. correct. and complete.
Signature of Assessor
App
True Cash
Value
(1) S_o0
(2) �7•,tLG7
(3) R '510
(4)_/901)
(s) A ? 90
(6) 19 /D
(7)
(8) f 0/ 0
- ACTION BY AUDITOR -
Assessed Homestead
Valuafinn Valuatinn
C
Date
Date: