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Homestead_Schatza a CLAIM FOR HOMESTEAD PROPERTY TAX s CREDIT /STANDARD DEDUCTION State Form 5473(R2/5-92) INSTRUCTIONS: See reverse side for filing instructions. FORM HC10 WrA I (We) V 1 v — certify.that on the 1st day of March, 19 I.(We cupied as ur principal place of reside ce the following described re I property for which a Homestead Property Tax Credit is hereby claimed: (We) owned ❑ Are buying under contract ytlgf � i Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the - ertIr fg- bdy&antract. If buying on contract, Fee Simple owner's name - 4UXA.1 A. %%r..,YC Page PROPERTY DESCRIPTION County Township I . Taxing district (c y, town towns i r P c�l u er — _ at description It any portion of the residential structure or the land not exceeding one (1) acre that immediately 4mmunds that structure is used to produce income,, describe the use and portion of the property utilized to produce income. / ev PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County Township I County ITownship certify the above statements are true, correct and complete. Signa� claimant (number and street, city, state, ZIP code) ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL VALUE and not exceeding t (one) acre immediately surrounding residential improvements. (1) - Otherland (2) Total land (line I 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 jobs line 7) (g) I hereby certify the above is true, correct, and complete. Signature of Assessor Date signed Verifying action - Signature of Auditor Date signed STANDARD DEDUCTION ALLOWANCE 19 _Pay 19_ Lesser of 112 Homestead Valuation or $2.000 S Signature of Autlit Date ignetl il!TEtnRnl!!'M10./YNI TRUSWI£R PORN TSIA BF/ROVED IMPORTANTTNOTICE TO HOMESTEAD PROPERTY RO��OWNERS L` Gibson County Auditor 101 N Main PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes 5 more beneficial.there is more incentive than escr for homestead fraud.Homestead fraud causes higher tae bills for all:therefore. 0 HEA 1344--2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the benefit and to provide additional identifying information nrcessazy to allow county government to better monitor homestead filing>.'Ibis information will he kepi confidential and can only to accessed by authorized county officials.The Ikpanntem 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 Schatz, Norma/Roger D Osborn '7 S-27 At 75 E ---R 1-fArc w Aaa ,S - Hazleton IN 47640 Q 1 ^�� Nor ma Schatz 190 Norma ' 1 7887 N 75 E State Parcel Number Legal Description HAZLETON IN 47640-9233 Itlnilutlrilntinlliutltln nitlnllu tlltlnit lt ttllt tt il 26-02-58-014-001.583-018/010-01cR9-O0 PT MD 14 1101.50 AC (VT? PART 2:TAXPAYER INFORMATION • Owner I First Middle Last ,I/ORinA J. SCKATZ - — .._. __. 1 I property W.s �c AAUrcas(ntunfier nna'Iran[.ctN:stare,anti ZIPcode'.—_ .—____._ �.sums ra - y_d .____ _ -- — . _ - 7217 N 75 C- yy2La TeA/ „7.,2 V76Y0 - Syr " First Middle Last Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address 7 & 7 75 E /-//9ZL e %e.4./ 1v . . Y s N 7eY0 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 INFORMATION •