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APPM*En BY SISIE YMRD OF VYTRANIA.Inn PRFAWBED BY ow DEPMINLYT(f LOCAL C.MZRVMFxT FINANCE MVI.1-2:-tI
: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 tier for homestead fraud homestead fraud causes higher tax bills for all:therefore.
REA 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 necessity to allow county government to better monitor homestead
filing'.This information will be kept confidential and can only be accessed by authori,ed county officials.The Ikpanntcnt of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
Hickman, Evelyn L
R3 Box 134
akland City IN .el
8673
Evelyn L Hickman
9047 E SR 168 State Parcel Number Legal Description
Oakland City IN 47660
26-20-15-400-001.783-001 001-01783-00 PT NW SE 15 3 9 4.996 AC
D-8
X
PART 2:TAXPAYER INFORMATION
Owner I First Middle a Last
�Ig Address(nu and street.city,state,and ZIP code) - Fl Same as property address - --—
9ol/7 f�. ,h1. �!• (GS a , jtA., 4764c
Spouse First Middle Last
NA
Mailirm Address(Number and steeL city,state,and ZIP code) Same as property address
Social Security Number(last S digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
see
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
CLAIM FOR HOMESTEAD PROPERTY TAX Fovea YEAR
CREDIT /STANDARD DEDUCTION HCto
St ale Fum 5473 (R715-M
Presorbed by the Departrnerd of Local Cavernmard Fmance
INSTRUCTIONS: See reverse side for ffiff?g inshAcdons
I (Mte) FAe�&� Or —ce" that on the I at day of March, M_
1 (We) occupied as our prirfps] place of residence the following de=ibecl real property for which a Homestead Property Tax Credit is hereby claimed:
I (ft) 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 the property or is buying under a oonbaLt
y
`i�'�,CC)trrFtACT.,FMCC)FtDEZ);P,"-�'.'r-', i..,€z Sitf qN
tf buyvV on cordracL Fee Simple owner's rams
Fam Zrderb afka when cordractisrecoi Record number Page
I . I
-PRoPER*,YoEscRlPndw-:
Canty
Towtship
T-dM district (aly, f r , to*TLW(o)
Parcel number
I LIUM description Y. TVcv .4
ler AW 151 IS .3 9 CT
the property in questim:
❑ Ped ❑ property Mobile Home (LC. 61.1-7)
If 4M porbon of the residential structure or the lard not exceeding are (1) acrv, that immediately anTmmxb Ond sbucture m used W produce inane, deqcrbe the use and patios
az pop" ubluad to produce income.
;Z0 L1110
0/. -7 8'3 - 0a/
7 rvt PROPERTY OwmED BYMAtht"T tOOTHER COUWMS
A4
County
Thimship
I County
I
I hereby certify the above statements erne true, correct and complete.
/Township
(nunbra end stno ol): siale, ZIP cods)
Vt',
6G
I I
STMDARD DEDUCTION ALLOWANCE r
20_Pay2O_
Lesser of 12 Homestead
VakLation or 535,000
SGnature of &4cktor Dale signed
,, TRUE tTAX
ASSESSED
;ASSESSOR USE ONLY .1
VALUE
-k
,
' VALUE �kAl"�,
Vt',
Land not exceeding 1 (am) acre i
W
surrounding residential improvemerts-
Other land
(2)
N
Told land (lute I plus fine 2)
(3)
Dwelfing
(4)
X,
Residential intprovenents or Annually
110-;RVOR,
Assessed Mobile I Manufactured Ficime
Garage
(5)
Other improvements
(6)
Total irnpravernents (fine 4 Uvough fine 6)
(7)
Tdal value (fine 3 plus fine 7)
(8)
I hereby certify the above is true. correct, and
complete.
Sq;nsbureafAssessor
Date signed
%knwv action - Sgnaturs of Auditor
Oate swmd
STMDARD DEDUCTION ALLOWANCE r
20_Pay2O_
Lesser of 12 Homestead
VakLation or 535,000
SGnature of &4cktor Dale signed