Homestead_Stuckey (3)CLAIM FOR HOMESTEAD PROPERTY TAX FORM
YEAR -
CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R5110 -01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
Ity t on ke 1stEa_y1ofj7Z% 20
I (We) mav� c
t d roe
I (We) occupied as our principal place of residence the following described real property for which s F1 rt I tij InbPaimed:
❑ 1 (We) owned ❑ Are buying under contract
Wave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the propKpol I &y2Q92der , contract.
'-.CONTRACT RECORDED-.-,
If buying on contract, Fee Simple owner's name 14tlBSON COLT MA
I Recorders office where contract is recorded I Record number IPage
0- -PROPERT.Y DESCRIPTION
County
Twm hip
Taxing district (city, totim, township)
Parcel number
L:mc t* 1.9/ 1 Is the property in �quel
—1-1
00
property
( 19c - . -1� 1-7)
OQ(0 eal property El Mobile Home (I.C. 6
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce imcorne, describe the use and portion
of the property utilized to produce income.
��—
r PROPERTY DIN N E D BY C LA I MA NT 1 ?4 OT H E R" C 0 U IN T I E
County
Township
I3 NON
County
Township
I hereby certify the above statements are true, correct and complete.
VALUE
ignat e cl imant
(n[�egl3c state P
67,
Pf
ASSESSED VALUE
-HOMESTEA6'-'
I3 NON
ASSESSOR USE ONILV��
--'-'VALUE,."::-_
AT.100*/.O TTV�
VALUE
-VALUF
Pf
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
_V
Other land
(2)
Total land (line I plus line 2)
(3)
4 _Irltl T
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
r5_,_
Total improvements (line 4 through line 6)
(7)
Total value (line 3 phis line 7)
(8)
I hereby certify the above is true, correct. and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
Silt teaM!3res twl TRfiNmmA FORM ttSIA
Ar FISWED DY MATE BsM(DOElrxxxtTc.An Paf5EATBm BY rill DEPARTS:EN LOEIAAL CATSRMMEN7 FDascr IC 6-1.1-'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 homewead fraud Homestead fraud causes higher tax bills for all:therefore.
• HEA 1343-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to Teethe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only he accessed by authorized county officials.The Ikpanmenl of
Local Government Finance will use this information to create tools that will help camp'officials eliminate homestead fraud.
; PART 1: PROPERTY INFORMATION
Taxpaver Name Property Address
Stuckey, Steven R/Amanda
• I Box 33-a
I 'a IN 47666
166
even R Stuckey
' 2219 W 350 N State Parcel Number Legal Description
PATOKA IN 47666-9024
111111111111111111111111111 IIii,,tIll'11111111111111tillliii 26-04-26-100--0 000.857-018 C
`J 70-00857-00 PT NW 26-1-11 1.91 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.
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
t M fi V. rE7
mg m
Address(number and street,ci ,state,and ZIP code) Sae as property address
�aa /y 35- 0 P f® ( l ///
Spouse First Middle Last
4m4-47904 -744-47 �5 vc/ E st
Mailing Address(Number and streel,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's Licence/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
• --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 Si torc ' Date.
PART 4:ADDITIONAL INFORMATION
•