Homestead_LongabaughCLAIM FOR HOMESTEAD PROPERTY TAX
i CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5.92)
INSTRUCTIONS: See reverse side for filing instructions.. -
W
FORM
HC10
YEAR
C TIFICATION TATEMENT .- yl p
} rr
I (We) O certify that 1j1 st day of March, 19_
I (We) occupie our principal place of residence the foil ing described re I ope9-- for which a HAAt®stead Pr Tax Credit is hereby claimed:
❑ I (We) owned ❑ Are buying under contract 1 IADfL+ I tjji
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property an hat owns thQ prq�,erty or is uyigg under a contract.
CONTRACT RECORDED = ^Fi'!N (; ::LI!cT> ?'tD1TOR
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded -
Record number
Page
p PROPERTY DESCRIPTION
County
Township
Taxing .c own s )
P I number `() d ^ _ 3
Legal de
If any pion of the re! s ucture or the land not (1) acre that imm d'mt y surrounds that Wucture is used to produce income, descnbe the use and portion of
the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
�reby certify the above statements are true, correct and complete.
Sign u of at 't
tltlr ss (number and street, city, state, ZIP code)
7l Yp
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(2)
Total land (line 1 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 plus line 7)
(8)
1 hereby certify the above is true, correct, and
complete.
Signature of Assesor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
Valua n or 52,000
$
Sig 1 ditor
Date
S1 VE FORM!Mt.tC/',II THE SUtfl PORN(11a
AP/ROVED BY SPa.BOARD Or ARS"L+TS!,m PtEARIBEW BY fir DEPART�YT OF LOCAL rOVERYMFA'T reascr IC t!--_4.I
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 eser for homestead fraud Homestead fraud causes higher tar bills for all:therefore.
al HEA l344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept con€demial and can only 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.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Longabaugh, Joshua A/Lisa L
P O Box 106
Hazleton IN 47640
277
Joshua A Longabaugh
R1 Box 81 State Parcel Number Legal Description
Patoka IN 47666-9109
26-05-58-042-002.303-018 010-02303-00 PT MD 421 10 3.00 AC
IIIIIIIIIIIIIIIIIIIIIII Ittllllrr r,Illlrlllltlllllllllllllllll D-12-C-1
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.
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PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
l . .. : ice „.„i . i .
' g Address(number Bad street,city,state,and ZIP code) E ,•as props i'dress
155Y Al T,,,, - R/ ,S7)A0, -71 1/7/0'
Spouse First / Middle / Last
LL Sr L yn.i ��An/ga,i4l
Mailing Address(Number and street,city,state,and ZIP code) I , acur as propert addre s
f 5'q Ail ozeff ,O /?a is C/7( ( LJ
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.
Own I i Date (
PART 4:ADDITIONAL INFORMATION
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