Homestead_Hoehn (5) 44c v- CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT/STANDARD DEDUCTION HC10
\�. State Form 5473(R2/5-92)
- - 6VSTRUCTIONS•See reverse side for filing instructions.
CERTIFICATION STATEMENT -
"`re) •.4I.'. 1 AS A a, i// JI_ / / , certify that on the 1st day of March. 19
t )occupied as our principal place of residence the following describ/real properly for which a Homestea Tt ax e i- by claimed:
7�I �t
�(We)owned ❑ Are buying under contract �_ _{�� .�_ ,r
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or ibbryyier a contract.
CONTRACT RECORDED '/ t�6rp 8-(- T1 -c
It buying on contract.Fee Simple owner's name "°'"V
:AUDITOR °
Recorder's office where contract is recorded . Record number Page
PROPERTY DESCRIPTION .
County 1 Township T ning district(city.town.township)
Parcel number ption
i i .6199-Cd I Legal de clij-- LS to HE a 9- 3-1.2_
- If any portion of the residential structure or the rand not exceeding one(11 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 COUNTIES
County Township I County �--� 'Township
.�eby certify the above statements are true.correct and complete. i n lure o claimant
Address(number and street,city,state.ZIP code)
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1 (one)acre immediately
surrounding residential improvements. (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Dwelling I(4)
Residential improvements
Garage (5)
I Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8) I I
I hereby certify the above is true,correct.and Signature of Assessor I Date signed
complete.
'-dying action-Signature of Auditor Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19
Lesser of 1)2 Homestead •
Valuation or$2.000 $
Signa:ur Auditor n (�//� Date signed _ - 9 5
_ 511VE FOR.M`)S*gR/wit IREAnJI@ FORM"41st
.APPROVED BT VOTE.!4WD OF MTTR:1TR_nn PP3_tttaam BY TIM DEPART4.`rt OF LOCAL G 5TtMMOlr FM:ANCE its-u t-rat
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead .aandard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ecr for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HE.\ 1344-2009 requires talpayen who receive the homestead standard.deduction to verity that they arc eligible to receive the
benefit and to piacide additional identifying information necessary to allow county government to better nronnor homestead
filings this information will he kepi confidential and can only he accessed by authorized county officials The Depannten of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead timid.
PART 1: PROPERTY INFORMATION
I
Taxpayer Name Property Address
• Hoehn, R Dennis 5
. _ .. _ _ _ - _ _ _ _ _ _ - —__ -__� _ RI VOX 172 47665 C\ ��
OWHNSVII.I.li IN 47665 n
6440 �-1V� f,'l
R Dennis Hoehn l b
8985 S 1075 W State Parcel Number Legal Description
OWENSVILLE IN 47665-8860
(Il 26-17-29-200-000.844-021 005-00844-00 PT SW NE 2931212.AC
n��ul�l��ul��nt�t�r�n�F�n�n��u��nl�u�l t�t�t�tt t��
7( D-20
PART 2:TAXPAYER INFORMATION
Owner 17 First Middle i Last
/4ON"i 1JGnr.-) .S NOCA i
- •ng Address(number and street,city,state,and ZIP code) ^- - -- -- —U.kdfne a4property eddresi -- -- — -—
Ce5985s /o -) S L ,
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) fTl Samproperty address
O9S5 S /0-) S LA.) tL�Sdc'
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 Signal / Date
• ,