Homestead_Allen (2) •
' LLVtrnksl 35'i r/star TPEYSULE2 FORM 71-1A
NnttA'ED BY',TM.atMPDrW MTTl'4%1%."no PR/SCRIBED BY Ter OFPNt1 e4T Or LO AL raN<RMMrAn Fn:ASCE IC 41.1-r4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to oar homestead sandani deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ner for homestead fraud.Ilomestead fraud causes higher tax bills for all:therefore.
lb HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to remise the
benefit and to provide additional identifying information necessary to allow county goverment to better monitor homestead
filinrts. This information will he Arya confidential and ran only k-aeme'e.el by enthralled county officials.The Dryunnrent of
local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Allen, Martha E Trust
R I Box 54 II
Owensville IN 47665
5814
Martha E Allen
7133 W Short Lane State Parcel Number Legal Description
OWENSVILLE IN 47665
26-17-01-300-000.003-021 005-00003-00 PT SW 1-3-12.68 AC
PART 2:TAXPAYER INFORMATION
Owner I /) First Middle /(n{' Last
ill I_ r t L a ' i // !�
ng Ad (number and street,city,state,and ZIP co�de)�,�.(t'� 0 Same as property address
Spouse First Middle Last
Mailing Address(Number and street.city,state,and ZIP code) ❑Same as property address
Social Security Number(last 5 digits) - -Driver's Liccnsc/State ID Number (last 5 digits) - -Other(plcsc spvdfy in Part 4 below)
Sate
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
e1Jn1..(ot_, tt 0,(1dr— e 1%.q.‘ e1 Jd (1, 6, 4rcc.5- 6 -e fore CH
rt- h (Itir1 F. 7/33 W ,s ..a-1- S. ti
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
t State Form 6473 (RS 110-01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for (ling instructions.
as �z..� =�z `CERTIFICATION STATEMENT ;r'y:",E'�.,1a- ,'- �sk+,j'
1 (We) certify that on the 1st day of March, 20
11,(We) ocou iad as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
6I (We) owned El Are buying under contract
1 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 under a contract.
sn' '� CO NTRACT*,RECORDED
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
- ,,,.
�' aPROP, ERTI'.DESCRIP,TIONt�?.�.�'`�,�. css'�'�.��`- .�r.�;;.�•
County
Township
hereby certify the above statements are We, correct and complete.
Taxing district (city, town, township)
P rcel numberJ� /��
L al de ption
Is the property in question:
PVC 0
3
•69
C ❑ Real property ❑ Mobile Homo (I.C. &1.1 -7) .
If any portion of the residential structure or 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.
(3)
L- -
- oao, L
3'.� ;ti �_��_��, -- 5��'� -.��` PROP. ERT: YOWNED; BY; CL' AIMANT ;IN',OTHERCOUNTIES,�`�'.m'� �`'�'."*,..�- '��.�'���i11PM
County
Township
County Township
hereby certify the above statements are We, correct and complete.
Signature of claimant
•ess (number and street, city, state, ZIP code)
L
ASSESSOR 11SE ONLY -= r R
�" e„- -,r-n r?.. 3r s _&5# ii;I`�,r„ 5•`€ ,
UE TAX*
,VALl1E
ASSESSED VALUE
AT ;1006VOFTTV,.�s
y OMESTEA6
VALUUUUUtiU,
NONRESIDENTIAL r4
r VALUES
.. _ ...s
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
$
Valuation or $6,000
-
Otherland
(2)
at igned
9
q.... _
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
,� «. /fi x 53
�.-" "m
E�s
Garage
(6)
_
r_;r�;
__
Other improvements
(6)
ONE ON - - x
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
AIIIIIIIIL
- cs"a =7 r3 -* zv s; .- ' STANDARb:DEDUCTIONALLOWANCE
20_Pay 20_
Lesser of 1/2 Homestead
$
Valuation or $6,000
Signature of Auditor
at igned
9
"