Homestead_FrazierCLAIM FOR HOMESTEAD PROPERTY. TAX
CREDIT/STANDARD DEDUCTION'
State Form 5173 (R614-031
Prescribed by the Department of Local l-Go4rnmeAl Finance
INS MUC VIONS: See reverse side for lifiml
FORM YEAR
HC10
Fl.
I
I (We) V Y LAA 0- C�- I V ) 10 1�) \��6 Q' A 0 certify that on the lstjday of March, 20
11 e) upied as ur principal place of residence the following described real property for ich a HomesteacipwP &&t is hereby claimed:
I e)
❑ We) owned ❑ Are buying under contract U
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.
ONTRACTRECORDED-ft,'-:'�-`
f buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
-*.:PROPERTY DESCRIPTION
County
Township
Taxing
town, tow np)
-
Township
I
�'yj
I
J7. ,.I number
at - 6 -=-C)j-L4 -�=l -3 -=--qj —
Legal descriPtion
C5 �-Itj - I - I
-
Is In properlin
I
question:
QA'e l property ❑ Mobile Home LLC. 6-1.1-7)
If any porlion of the f . n, the
- ll) acre that immediately surrounds that sActure
is used to produce income, describe the use and portion
of the prop" utilized to produce income.
-1,5
surrounding residential improvements-
'04
49 4
W
PFi6P.tfitY&WNE6BYtLAIMANt;lhiOTHER-COUkTitS
-.r
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant
Ug
Valuation or S35.000
,190%?OFj!TV-�,
ress (number and street, city, state, ZIP code)
0 . 6 ;) 10 -
49 4
W
F.�JRLJEtTAXt,i-4-;�
ASSESSED VALUE
W9HOMESTEAD
-V -k
I
ESIDENTIAL,,'�
Lesser of 112 Homestead
7$
6E
SAT
Ug
Valuation or S35.000
,190%?OFj!TV-�,
ignaturo of Auditor
Land not exceeding I (one) acre immediately
surrounding residential improvements-
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Met /Manufactured Home
Garage
(5)
Other improvements
(6)
Trial improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
i Date signed
complete.
Verifying action - Signature of Auditor
Date signed
pipe
!.STANDARD. DEDUCTION-ALLOWANCE
20 _ Pay 20 _
Lesser of 112 Homestead
7$
Valuation or S35.000
ignaturo of Auditor
Date signed
SLATE FORM!3I (RCS DII TREASURER PORN 31A
VIRMEO BY STATE EOSRS OF.scrous s.zus PRESCRIBED BY 111E OFPARDIESTOEL Q(OVPRVMThT FINANCE IC 4-1.1-L4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and hurried couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than eser for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
1 t HEA 1544 2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
s benefit and to provide additional identifying information nsysssaly to allow county government to better monitor homestead
,l nd filings.This information will be kept confidential and can only he accessed by authorized county officials.The Department of
I Local Government Finance will we this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
APR 9 LULU Taxpayer Name Property Address
_
`-y�7 Frazier, Clyde T
7/0c RI Box 265
GIBSON COUNTY AUDITOR Hazleton IN 47640 (I
22 4 i1 i}[.
Clyde T Frazier r
V
P O Box 105 State Parcel Number Legal Description
HAZLETON IN 47640-0105
Itrt�r�t��tttt�t�r�tt�ti 26-02-48-101-001.443018 010-01443-00 PT LOC 1011107.54 AC
tittiittritllrrrirrllirrrll Ilii
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: TAXPAYER INFORMATION
Owner I First Middle Last
G/ yOL.P. T4-rvi er Fr(4., z ,'er
mg Address(number and street.city,state,and ZIP code) El Same as property address
P, 0, 66X I 6 192q t G4ra t(2 a.1, Ha-zle1oh Tti y26Ye
Spouse First Middle Last
C La
,4v-4-L n n /SCI tt ;elle Fret-21'C(-
Mailing Address(Number and street city,state,and ZIP code) ❑ Same as property address
PO, 3try l or / 12q E C- re Pea 4 st !iatile>tor, r,-,, '176 (d
_
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
• Ir