Homestead_ReisingCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 IRS 110-01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
FORM YEAR
HC10
I (we) ea ii I It A vs, S20 r= certify that on the 1sb62i of March, 20
I (We) occupied as Wr �aipal place of residence the following described real prcz�jey for which a Horn
esteaj Oiopehy ?ax6,edit is hereby claimed:
❑ l(We)owned ❑ Are buying under contract
Wave a beneficial interest in the entity that is liable for the property taxes on the property and that oi%L.6 Or gu-y'Q-L-r-�acontract.
' CONTRACT!RECORDEDKI�-
If buying on contract. Fee Simple owner's name
Recorder's office where ecorded jlle2r number Page
County T nship Taung district (city. to", township)
Parcel number Legal description Is the property in question:
�p T 5 + Y"� 17:1 — — C? ❑ Real property ❑ Mobile Home (I.C. & 1.1 -7)
ff
any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to Produce income, describe the use and Portion
of the property utilized to produce income.
/1 (:�1
1 0- 0- 1 � -/00- 00 /
W-AFAI
8'3 J -001
'FWP ti�"°�-a-��pkop.EFitybwNE6-BYCalmAht
`J, -TRUE XAX �rft
County
Township
County —Township
I hereby certify the above statements are true, correct and complete.
Nfinature of cla, nt
N
Tess (number and street, city, state, ZIP code)
02
`J, -TRUE XAX �rft
:4SSk -gSi A
;QHOMESTEADj
MVAL61il
A-
Valuation or $6.000
'dz'i
Land not exceeding 1 (one) acre immediately
Date signed
I
surrounding residential improvements.
Other land
(2)
-IZEZ�4 e -
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (fine 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
TAN DAR D. D E D U CTI 0 N ALLOWANCE
20 _ Pay 20
Lesser of 1/2 Homestead
7S
Valuation or $6.000
SV ture of d1or
) � N , , _ Ij
Date signed
I
STATE FORM 53569(Nn-10) TREASURERFORM TS-I
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1 22-S.,---___
;: i ' IMPORTANT NOTICE TO HOMESTEAD-PROPERTY OWNERSiz
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
'^duction 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 benefit and to provide additional identifying
information 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.
t - < r PARTC-PROPERTY INFORMATIO 'e?` . ' a a .. 'F C'
...... dr... .. +1 :� . . .. . ., . ...... . � , � r, �.i G .`.....tn 1a1 n ': •, ,r il.",
Taxpayer Name Property Address State Parcel Number Leeal Desr'riptiont
Gregory S Reising 6568 S 700 E 26-20-17-100-001.831-001 PT NW 17-3-9 1.00 A
FORT BRANCH IN 47648
Complete and return to:
-_ IIIl IUJ91 4tUl gae U1 t1 E UI0 1LL7Ia -
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
,R. 4 ;"i„-*'.
i.' _:k -r'" `; ''°PART 2:TAXPAYER INFORMATION, . ! , { .,�x '; '' '" 4 :':
Owner 1 First Middle ✓� ,. Last
(' ref— SCI, /� -QlSncLc
Matting Address(number and sheet,city,state and ZIP code) ��as property address
. l g 5&" - c - 700 q Q S/ F T-e r-4 tic l t f.it/I tI?6 Y (
Spouse First Middle r Last
Mating Address(number and street.city,state and ZIP code) I Same as property address
°6(p% S r\ ? �i3 CL'51QX, 2i +. ,,,g8
1 _
—ace- ::..' a ( • ,..±,-*:- .!w( >sv^ s'tyj' z gc se -t _
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 1 Signature Date
k tCi:"u•ii ,. , t -rr ' ,,a •- ••;PART„4:,ADDITONAiNFORM• TIQN I� n, a r Z:•,,C
it.- a
I. i�
• DEC 31 2012
,\ rV\
GIBSON COUNTY AUDITOR