Homestead_Graper (2) -
STATE UM!3'alit:/HNI TREASURER HAM-}IA
APPROVED
IMPORTANT NOTICE TO HOMESTEADEPROPERTY OWNERS
Gibson County Auditor
101 N Main
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 eser for homestead fraud Homestead fraud causes higher tat bills for all:therefore.
• HEA 1344-?G06 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necesary to allow county government to better monitor homestead
filing.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.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Graper, Michael Ray
203 N Lincoln
Fort Branch IN 47648
10
Michael R Graper
203 N Lincoln State Parcel Number Legal Description
Fort Branch IN 47648-1113
1t1rt11ttt1r11rmt�t t��rr�trt t��ttt��ttt��tt��t�� ��rrt�r�� 26-19-18-303-000.614-026 011-00614-00 WALTERS ADD 346/13OPT
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
/c'6- SAY 6 /9-/°/>'7<_
on,Address(number and steer.city,stare,and ZIP code) Et Same as property address
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sate
PART 3:CERTIFICATION
— Each undersigned certifies,-under-penalty of wnttry,.that.the above and foreeoine.information is.true.and.correct and thathe 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
•
i�-
SLAT£FORM!!K12'/BOB) raLASUant PORN 1IA
APPROVED IMPORTANT NOTICE TO HOMESTEAD rPROPERTY OWNERS
Gibson County Auditor
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one homvead 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 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
filing?.This information will be kept confidential and can only be accessed by authorized county officials The trpanntent of
Local Government Finance will use this information to create toils that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Graper, Michael Ray
203 N Lincoln
Fort Branch IN 47648
10
Michael R Graper
203 N Lincoln State Parcel Number Legal Description
Fort Branch IN 47648-1113
�r�rr��rr t�r��rtt�tr��tt�tt tt��rt t��ttt��rt��r�� litrsirll 26-19-18-303-000.614-026 011-00614-00 WALTERS ADD 346/130PT
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
/G%fl%L /2-742-y 6x.49-/c9c---/<_
g Address(number and street,city,state,and ZIP code) EL Same as properly address
Social Security Number(last 5 digits) - Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
705-0 state J 1--/(9
Spouse Middle Last
A //
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sore
PART 3:CERTIFICATION
— Each undersiened certifies,.under-penalty.of rorntw;that.the ahove.andforeeoine.information is.tme.and correct and that.he or_she.is_elieible 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 Telephone
y/7� O (g7am) /d
Spouse Signature Date Telephone r
PART 4:ADDITIONAL INFORMATION
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2 / S92)
INSTRUCTIONS: See reverse side /or filing instructions.
FORM
HC10
YEAR
CERTI TION STATE NT
'' „ .
(1.1 �
I(We) � 'fy that he �st ay�ofA�;c 1
I(We) occupied as our principal place of residence the following descri real property for which a omestead Property T�Q CredO�it is heretiy c ed:
❑ I(VJe) owned ❑ Are buying under contract '"'� �����
❑ Have a beneficial interest in the entity that is liable for the property ta�ces on the property and ihai owns the pro or is buying un r a coniract.
/
� CONTRACTRECORDED �.
Ccn i
I( buying on contrad, Fee Simple owners name � "'`• " n
Recortlels oflice where contract is recordea - Record number Page
PROPERTY DESCRIPTION �
Counry 7ovmship Ta�cing district (ciry, town, rownship)
�el number � � Legal tlescnpiion � �
It any ponion of Ihe residential structure or.the land noi ezceeding one (1) acr that i�ounds iha[ swaure is used ro Produce income, describe ihe use arW ponion of
the properry utiizetl ro protluce income. 1^ O�
ICJ
PROPERTY OWNED BV CLAIMANT IN OTHER COUNTRIES
Counry Township . Counry Township
ig ature of dai`�� .�
,ereby certify the above statements are We, correct and complete.
Ad ress (number and street ciry, sfate, ZIP code)
Z O.� N. L/�/G O Ln/ �-D �T B2i9�vG� / r/ �% 6 S� A�
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately ��)
surrounding residential improvements.
Oiherland (2)
Total land (line 7 plus line 2) (3)
� Dwelling (4)
Residential improvements
Garage (5)
Oiher improvements (6)
Total improvements (line 4 through line 6J (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is We, correct, and Signamre of Assesor Date signed
complete.
Verilying actlon - Signamre ot Autlitor Date sgnetl
STANDARD OEOUCTION ALLOWANCE
19_ Pay 19 _ .
Lesser of 7/2 Homestead e�
Valuation or 52,000
Signatura ot Auditw � Date signetl
5- S- o