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Homestead_Buente atAR FORM LV+gu wt MASOREA FORM 73.1A
.APPM■ED BY SIAMennRonUAmmitas,M1r. PREYTtBEDny nit DEPARTOMWL($At riw£RYMEAT FINANCE IC 4-1.1.224.1
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 dedanion becomes
more beneficial.there is more incentive than ewe for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1341-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
tiling.This infomuton will be kept confde iial and can only be accessed by authorized county officials The Ikparnrent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Buente, Theresa M
RI Box-/-/
Fon Branch IN 47648
7992
Theresa M Buente
7912 S 45 E State Parcel Number Legal Description
FORT BRANCH IN 47648-8011
��tn��nt��tt�t��tt�tl 26-19-19-204-001.314-026 007-00438-00 INDIAN HILLS 76/77
/ D-27
PART 2:TAXPAYER INFORMATION
Owner I First qq Middle Last
r 5 9 /1 a r r}-
ng Address(number and street,city,state,and ZIP code) i— _--- - - •me tis property addiess
/3ir-4evc. h
Spouse / First Middle Last
Mailing Address(Number and street.city,state,and ZIP code) El Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please spy if'in Part 4 below)(
sue
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.
lT.'nCrl Signature Date
� CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
♦ � State Form 5473 (R6 / 4-03)
Prescribed by t�e Department o( Local Govemment Finance
WSTRUCTIONS: See revcrsc sidc lo� liling inslrur,fious.
.._ . _ �,.m. z�.....;,,�...:- ... ._.. -
FORM � YEAR
HC10
`�-.r� �:. _ y . - . �,. ..,, ._. . �. : CERTIFICATION STAIEMENT "� .. •_ ..- . -- �
I(We) cerlify that on Ihe tst day of March. 2� 1
I(We) occupie as our principal place of residence the following descnbed real property for which a Homestead Property Tac Credit is hereby daimed:
❑ 1(VJe) owned ❑!ve buying under wniract
� Have a benefidai interest in the entity ihat is liable for the properry taxes on the property and that owns the property or is buying under a coatract.
If buying on conired. Fee Simple ownefs name
Remrdels olfice where contract is recorded
Rewrd number � Page
y�,cresx.. +=' - `��r.�-�••-: � PROPERTY OESCRIP,TION'�: . � ... , � ..- . �'-:x` . = -
Couniy Township Tacing distric� (city, Iowq township)
P cel n her `y'r��(nz / �`/ L al escnD'on.. tha O�openy in question:
� 1./U� w ? ❑ Real property ❑ Mo6ile Homo (I.C. bf.1-7)
II any ponion of ine resiCential strucwre w the WnE not axceeding one (1 � acre that immeaiatery sunounds that swaure is used W v��uce income, describe ihe use and portion
ot the property utilized to produce iriwme.
� � /
r�a���i `ASSESSOR�USEONLY � � ,TRUE�TAX ASSESSEDVALUE -�� �HOMESTEAD - - NON-RESIDENTIAL,
�`,.�"��'jY'.�i.: ,-a i;.y:.-y:. ---'VAL.UE "AT100%AFTTV - ' VALUE..'�. •.;:;�'VALUE. .
Land nol exceeding 1(one) acre immediatety +,'�, - �.-
surroundingresidentialimprovements. ��) . �� � �
Other land (p) - �- _ �
TUaI land (line 7 plus line 2) (g�
Dwelling (4) ,:��:-'.•-�z;-,•s`,:%";:;;;.;` .�.. -
ResidenUel improvemenLS or Annually ' �' - - � " � '`' "' -�_
,�-,:T�.�-��7r:->,-=='',:_�.�, �....
Pssessed Mobile I Manufactured Hane Garege 5 '�i4=..:�.';%�: �-'>'1-�%�.. �� _
( 1 i�.:, .. `.>_ '.
Other improvements (6) -
TUaI improvements (line 4 throuqh line 6) �7� �
Tolal value (line 3 pl's line � (g)
I hereby certify Ihe above is We, cortect, and Signamre o(PSSeswr Oate signed
complete.
Ventying acl'an - SignaWre of Fwdilor Date signed