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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
•�'I State Form 5473 (8215-92) -
INSTRUCTIONS: See reverse side for riling instructions.
FORM
HC10
i3Ae Cl ilk' S I
YEAR
CERTIFICATION STATEMENT
I (We) ity tK�n ®e lst of March, 19_
I ( We) upied as our principal place described re roperty for which a Homestead Property Tax Credit is hereby claimed:
(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 act.
/t' . rL. > +T f
y 'ITOR Af;
CONTRACT RECORDED
It buying on contract, Fee Simple owners name
Recorders office where contract is recorded -
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing di ( , town, to hi )
r
a
yFpu= b(-N') ^_O^
Legal descripdon
If any portion of the residentitialLl stmctureUor the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of
the property utilized to produce income-
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
Sig azure of claunarit
. , ereby certify the above statements are true, correct and complete.
' Address (number and street, city, state, ZIP code)
I 6)y H p D H&?_(e�f0f\ _S_11J I-RCn o
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Other land -
(2)
,
Total land (line 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 of Assesor
Date signed
complete.
verifying action - Signature of Auditor Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead
S
Valua'on or S2,000
Signature of Auditor
Dates ed _ o ^
U
STAR FORM s 1)W 10.!YMI TAFASUR U FORM TS-IA
APPROVED BY ASTE BIHRD OF SUNLST4'm+ PREstinmDDY THE DEPARTME4TOF LOCAL GOVERNMENT FDUNCE IC 61.1-1_4.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS a
PRINCETON IN 47670 Individuals and married couples are limited to one homestead :unclad deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud.Ilomesteael fraud causes higher tax bills for all:therefore.
HEA 1344-70119 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reeene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing.This information will he kept confidential and ran only be accessed by autbori,ed roomy officials.The Ikpannent of
Local Government Finance will use this information to create tails that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
- Taxpayer Name Property Address
Talamantes, Eduardo A/Julie K
R140D
Hazleton IN 47640
380
Eduardo A Talamantes
5656 Old US Hwy 41 N State Parcel Number Legal Description
HAZLETON IN 47640-9222
26-04-12-400-002.292-018 010-02292-00 PT E SE 12 1 11 5.00 AC
I I toIt II toI n III sat I tI nu I t I o I tI..I II t I t I I I IIt I
PART 2:TAXPAYER INFORMATION
Owner I r� First Last
Cductrdo A TQta -ife-s-
ion g Address(number avid street,city,sure,and ZIP code) .-- - ' __ ' . ' n Sane as property address —• - -- —
sXo ( 0(d US w y din I-(ec -0,, h694
Spouse First Middle Last
•
Sijt.v.� I. TQ(a n-vz-V-cs
Mailing Address(Number and street,city.state,and"ZIP code) ❑ Same as property address
So St7 \I cam) VS ficay q( ( 24-SzczA -n j `i-7/ c j
PART 3:CERTIFICATION
Each undersigned certifies,under penalty, of perjury,that the above and foregoing information is taste 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
a PART 4:ADDITIONAL INFORMATION
•