Homestead_PayneCLAIM FOR HOMESTEAD PROPERTY TAX
= CREDIT /STANDARD DEDUCTION
t ru State Form 5473 (RS/ 10-01)
Prescribed by the Deparhrrem of Local Govemment Finance
FORM YEAR
HC10 .3
I (We) L (.. certify that the ldavx1lfkIDrch, 20
I (We) occupied as our principal pr' of residence the following described real property fo ich a Homestead Proper y 4acL i -t is hereby claimed:
❑ I (We) owned ❑ Are buying under contract /n/ (/ /J
Wave a beneficial interest in the entity that is liable for the property taxes on the property and that owns t4epertyror�bl)yin9 -untler aEonfrad.
CONTRACT °RECORDED'i�'r`��'�'�y T�` `i- `�`�.'t�+''�'�s'ra�--'k'ti••:
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
- 3a-'.' '.'" `�. i i• . ' a.
w,.: -- s��r`ua�PROPERT:Y�OESCRIP170H
i;,,rt� e•`""6 r'z`) 4Sst�`' '_aa r,+
County
Township
mss (number and street, city, state, ZIP code) '
Taxing district (city, town, township)
Pa I m r
L 1 de p' n
-Z—
Is the property in question:
r j
❑ Real property ❑ Mobile Homo (I.C. 61.1 -7) .
H any portion of the residential structure or the land not exceeding
one (1) acre that immediately surrounds that structure is used to produce Inconne, describe the use and portion
of the property ubTaed to produce income.
�s���PROPER7Y,0YYNED;BY4CLAIMA TNER`COUNTIES��r�`���- �'"" "" r"r
County Township
Co t Township
I hereby certify the above statements are true, correct and complete.
na re laiman '
mss (number and street, city, state, ZIP code) '
-"`r ''ASSE850R,U ONLY `�•
Dea ».Q+c «w
TRUE TAX
1_...,�
ASSESSED VALUE
y�.m.:..'. .,..- .s, --Y:
HOMESTEAD1t
-- ..�xwauNr_x+ -�.+r - ;-f,
NON�RESIDENTVL.r
Xg- -: ,,�,¢ -sF,Za g-.-x r-11 �,
- 4/ALUE y
AT, 700 %OFTIY�y3
.^ ,,.VALUE
' ��'1`�VALUE '? ' ^''
ws4a r;,.s.�..
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
°? .t -*"
;B_
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(6)
'�3)�t� h�.i A9r.,'tti y
- _ �.
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus linen
(g)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Veitybg action - Signature of Auditor
Date signed
'o.,- ',`STANDARU'DEDUCTION` ALLOWANCE?;
mr 20 _ Pay 20
Lesser of 112 Homestead
Valuation or $6,000 $
Signature of Auditor Date signed
y
I
STATE FORM 5350 TATE B TREASURER FORM TETA
APPROVED BY STATE BOARD OF COIMi]D% PAESCRIBID BY TUE DEPARTMEAT OF LOCAL OOYR'MEVL FLVA`I,E IC 41.1-23A1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
' , 101 N.Main Street
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 ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
S FILED benefit and to provide additional identifying information and can necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PAR1' 1: PROPERTY INFORMATION
MAY-11 2011 Taxpayer Name Location Address
C Payne, Rodney WlHelena C
6200 S 650 E
GIBSON COUNTY AUDITOR FT BRANCH IN 47648
8716 1( I IIm��I II
Rodney W Payne IIDI�III�[IIIII�II �IIDIII I��IIIIWIIII II��IIIII II_IIIQI_I�I III DI(II�II_III101 II
62005650E
FORT BRANCH IN 47648-8573
III'Ii'IIIIII1III"I'1I"1'Ililt�ll1'11I1I"I11"IIIIIIIIII"I'I, State Parcel Number Legal Description
26-20-08-300-000.971-001 PT N SW 8-3-9 50 AC D-8
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.
E ). PART2:,TACPA\'FRyNEQRM.AT1OIS__-- --.: