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Homestead_Condiff SIME FORM flt..IC.0 w'1 IP.EASIAL3 PoRM 731A ArPR,w'FP BY SITE BMPWM MIx*.ST5_!wN Pr1 ,mmOY TIT DEPARTMENT OF LOCAL CUrRYMET7 FINANCE IC 4.I.I.r4.1 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 deduction becomes more beneficial,there is more incentive than e'er for homestead fraud_Homestead fraud causes higher tax bills for all:therefore. HEA 1343-2009 requires taxpayers who remise the homestead standard deduction to verify that they are eligible to recebe the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filings.This information will be Amt confidential and can only be accessed hs authorized county officials.The Department 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 Condiff, Charles H Jr/Cynthia L R l r`��, Pon Branch IN 4764&/ 3004 Charles H/Cynthia L Condiff Jr Jr. 7830 S 10 E •State Parcel Number Legal Description Fort Branch IN 47648-8001 It�rrlltrt�t��ttl�rt��tl�r�l r�r��r rr�� ��tr��r��l rr�r�rr� 26-19-19-203-001247-026 007 --00948-00 INDIAN HILLS 14 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 ,J/ First Middle J Last Address(number and street.city, and ZIP code) C/// ✓ ( Y. ) �►� Same as p a m 2F;',7 O /(7 . ,c" �� ✓L,. </71 y'�3 - Spouse First Middle Last cy„fti;Q L y�h eond-ir Mailing Address(Number and street city,state,and ZIP code) El Same as property address 7'3o Si /o . , Rrt &Dane-A, .city 4f7(p9f 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 Signature Date • 4� Si�tF O i � a :�''; �/ CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION State Fortn 5473 (R2 / 5�92) FORM HC10 � YEAR -n ' ; INSTRUCTIONS: See reverse side for liling inshuc6ons. � ��� - CERTIPICATION STATEMENT I(VJe) • ertify t on the 1st da of ch, 19_ I(We) occupied as our principal place o residence the flowing described real property for whic o estead Pn���,/t�^Ses�f is y clai ❑ I(We) owned ❑ Are buying under contract �BSON �p���,�7Y ❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the properry or is buying under a con�[ra�c�. � CONTRACTRECORDED� If buying on contract, Fee Simple ownefs name RecordeTs office where convact is recortled Recortl number Page PROPERTY DESCRIPTION • � Counry � Tovmship Tazing tlistrict (ciry, town, famship) P rce u r Legal description . tl any portion ot �he resitlential structure or ihe IarW rrot exceedirg one (1) acre tnat immetliarety ur untls i s ucture � use to protluce income, tlescribe the use and ponion of Ne property utitizetl ro protluce income. o?G -/9-�9 oTo.�- a�/. a� aa� . PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES County Township County Tovmship �qnature nt reby certify the above statements are We, correct and complete. Atl (numbe sfr et, c. fa(e, ZIP � � ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL VALUE VALUE VALUE VALUE Land not exceeding 1(oneJ acre immediately �� � surrounding residential improvemenis. Oiher land � (2) Total land (line 7 plus line 2) (3) . Dwelling (4) Residential improvements Garage (5) Other improvements (6) Total improvemenis (line 4 through line 6) (7) Total value�(line 3 plus line 7) (8) I hereby certify [he above is true, correct, and Sgnawre of Assemr Date signed complete. Verifying action - Signature of Autliror Date signed � STANDARD DEDUCTION ALLOWANCE 19_ Pay 19 _ Lesser of 1/2 Homestead S Valuation or S2,000 Signamre of Autlitor � ` Date signed ll..% 3— —Q