Homestead_Moody SWE FORM!r.'Nnl_t tWr TRFASU&EA FORM TI-IA
ArrR IMPORTA:IMPORTANT NOTICE TO HOMESTEADFP PROPERTY OWNERS
Gibson County Auditor
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sandard deduction.As the receipt of this deduction becomes
L �r--� more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
ari I- L 1 n q RCA 1344-2009 requires taxpayers who receive the homestead standard deduction m verify that they are eligible to race ee the
fy�l ./FN7 benefit and to mei& additional identifying information necessary to allow county government to better monitor homestead
7 filings.This information will be kept confidential and can only he accessed by authorized county officials.The Department of
Local Government Finance will we this information to create toils that will help county officials eliminate homestead fraud.
APR 0 7 PART 1: PROPERTY INFORMATION
2010
Taxpayer Name Properly Address
Moody, David C/Sandra G
Ca zoo w )1J(11
(..\\))—rBSON COUNTY AUDITOR s Patoka IN 47666 611/69
David C/Sandra G Moody
R 1 State Parcel Number Legal Description
Patoka IN 47666
26-04-14-100-0000.398-018 010-00398-00 PT S NW 14-1-11 5.443 AC
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.
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP ) 3 Same as property address
''15 / moo W _ � i(A _17-Ai 476(o 6
—'-� ._ ____ — --- - - -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.
PART 4:ADDITIONAL INFORMATION
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State I= 5473 (R4 I B-00)
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
FILED
,(
of residence the following described real property for whidU a Homestead Prb�perty Tdc-Credit is tiereby_cfawetf:
❑ I (We) owned ❑ Are buying under contract
cave 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.
TF�kC� -litECQIRD . . . . . .
If buying on =track Fee Simple owners name
Recorders office where contract is recorded Record number Page
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County Township
County
Township
Ta <ing district (city, town, township)
ant
P I umber
Legaidescription
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Land not exceeding 1 (one) acre immediately
It any Wr'on I the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to prod/
roduce income, describe theme and portion
of the property utilized to prod" income.
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County Township
County Township
I hereby certify the above statements are true, correct and complete.
SIT =fcla
ant
dc tuber a nd � state, ZIPde)
07 7
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Land not exceeding 1 (one) acre immediately
PRO
OHIO
surrounding residential improvements.
Rn"t.
Other land
(2)
Total land (fine 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
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, and
Signature o[Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
MIX-- "b . . . . . . . .
20 _ Pay 20
Lesser of 112 Homestead $
Valuation or $6,000
Signature of Auditor Dat