Homestead_Beach SUTE FORM!)!M,2/awl TRFASULDA FORM}IA
APPROVED BY crATE BMW OF ACMUNTS.].'r PRESSMTW BY MT nrr,anownOF LOCAL GOVER.VMFAT mi&tEICtt.I.i'JI
Gibson Count,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
e more beneficial,there is more incentive than eter for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344--2000 requires taxpayer ho receive the homestead standard deduction to verify that they are eligible to recebe the
benefit and to provide additional identifying information recessan.to allow county government to better monitor homestead
filings.This information will he Lett confidential and can only be accessed by authorized enmity officials.The Department of
Local Government Finance will use this information to create tarls that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Beach, Michael S/Maribeth
1003 S Center
Fort Branch IN 47648
2615
Michael S/Maribeth Beach
1003 S Center State Parcel Number Legal Description
Fort Branch IN 47648-1707
Itlt tlltrtlrlllrlllrlllrlttttillttt�11trl1l ll111 111111111
26-18-24-204-000.250-026 011-00250-00 BRENTON ADD 12/13
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
MT6HAEL ST Eu EuU B EA c 1-1
ng Address(number and street,city,state,and ZIP code) ome as property address
1003 SouTH CEFA/ 2 ST. R02T 62miudi rN 4 l707
)
Spouse First Middle Last
MAR_ ETH I3 IEAC
Mailing Address(Number and street,city,state,and ZIP code) e as property address
loo? Spurt/ CENTeJL c7T Foal- 132Ar"cu r,v 76q -/70 7
_
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury,that the above and foregoing infonnation 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
� zr„E o
.
: ���
e
e
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2 / 592)
INSTRUCTIONS: See reverse side lor (iling instrucSons.
FORM
HC10
YEAR
,� - C RTIFIC TI TATEMENT
c
I(We) � ity that' �p`{�7pt y ot ar 5 78
I(VJe) oc � as our principal place of residence the following desc�bed rea ro eAy for which a Homestead Prope�t�r�d s h r y � dF
r �L 1i
(We) owned ❑ Are buying under contract -
❑ Have a beneficial interest in the eniiry that is liable for the pmperry taxes on the property and that owns the property oS��ry��ncAnp�qoniract.
^
IJJJ
CONTRACTRECORDED �/ i f/'
If buying on contract, Fee Sunple owners name �; ;,J^-�-
. �isso.�,::.,...,.•; n.��oiTe�
Recordets office where conuact is recofded . Recortl number Page
� - PROPERTY DESCRIPTI �
Counry Towrtship Ta�dng d� i( own, town '
m � �� � Qegal description
It any ponion of the resitlential structure or.the land not exceetling ane (1) acre tha[ immetliatety sunounds that sWCture is usetl ro protluce income, describe the use arM portion of
the properry utilized to praduce income.
PROPERTV OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Counry • T
t
Signature ofclai nt
_reby certity the above statements are true, correct and complete.
Atltlress (number and sfreet, ary, slale, ZIP wdeJ '
loo E 5. F1'.�/3 Y�
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding t(one) acre immediately (��
suvounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2) - (3)
Dwelling (4) .
Residentiai improvements
� Garage (5)
Other improvements (6)
, Total improvemenis (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certiry the above is true, correct, and Signamre ot Assesor oare signed
complete.
Veritying acGon - Si9naWre of Auditor Date siqnetl
� STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead 5
Valuation or 52,000
Synature ol AWimr Date signed