Homestead_Loyd• a. CLAIM-FOR HOMESTEAD PROPERTY TAX FORM -YEAR
CREDIT /STANDARD DEDUCTION HC10
n >� State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
Q 1 r
I (We) N" A l o t is l cejtify that on the 1 st day of March , 19
(We) occupied as o principal ,ace of rest ence the following described real property for which a Homestead
P Say Tax Credit is hereby claimed: ED "'l (We) owned ❑ Are buying under contract
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 it under a contract.
CONTRACT RECORDED
If buying on contract, Fee Simple.-Owner's Name
S
Recorder's office where contract is recorded d ul'ber 1 Page
PROPERTY DESCRIPTION (: /i ?.Y
County Taxing District (City, town, township)
Parcel Number Legal Description AUDITOR
O /0 –Oa 301 —OD
If any portion of the residential_ structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
nnnoCOTV n1Alydrn av CI AIMANT IN OTHER COUNTIES
Count
Township
County
T W fP
I hereby certify the above statements are true, correct and
r lete.
Signatwe �)
q(Street, number, city, state and ZIP code)
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Otherland
Total land - line (1) plus line (2)
Residential improvements Dwelling
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
(1)
1989 Pay 1990
.-sser of 1/2 Homestead
(2)
1991 Pay 1992
Lesser of 112 Homestead
19 — Pay 19—
Lesser of 1/2 Homestead
Valuation or $2,500
(3)
Valuation or $1,500
Valuation or $1,500
(4)
(5)
S18f1dlo g1 Aggilgr
(6)
(7)
(8)
I hereby certify the above is true, Signature of ASSeSOr
correct, and complete
Verifying Action - Signature of Auditor
Date Signed
Date Signed
.nn nrnrrrTrn Al A11 nIAIAW -r-
Jln,�v�„v v
1989 Pay 1990
.-sser of 1/2 Homestead
1990 Pay 1991
Lesser of 1/2 Homestead
1991 Pay 1992
Lesser of 112 Homestead
19 — Pay 19—
Lesser of 1/2 Homestead
Valuation or $2,500
;1 Valuation or $2,000
Valuation or $1,500
Valuation or $1,500
S18f1dlo g1 Aggilgr
Date Signed
J/ _
c1NE Font.)!m ou two TREASURER MOW TS-IA
.ArrWn'Et BY MATE BOARD OfArmt:li. PRFY}1BFP DT Tiff OFPARTNENTF LORAL novrrntrn N:NCEc i.I-114.1
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 ever for homestead fraud.Homestead fraud causes higher taw bills for all:therefore.
41.
HEA 1344-2009 requires aypayers who receive the homestead standard deduction to verify that they am eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.ibis information will be kept mnlidential and can only he 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
Loyd, Danny W
Patoka IN 47666
1001
Danny W Loyd
1023E Steelman Rd State Parcel Number Lee& Description -
PATOKA IN 47666-9106
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PART 2:TAXPAYER INFORMATION
Owner! First __1 R•<)\--1E- Middle LCI\( Last
Aadress(number and street.city.start;and ZIP code) ' - - f Saic as property odds. - -- - -
102'3 et-eeLMg1J 9-12‘) • Pek-ro pCG , \y A'- lla CL-E,
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Drivers License/Stare ID Number (last 5 digits) Other(please hpa.ily in Part 4 below)
scut
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.
�er I Signature Date