Homestead_Hammer aTMt rOFM!!'M,Iel tnnl !AFASULER FORM 11A
ArrRIT ED Br Sr rat BMa°IK VTTfl75.`Ox PItt5i1USED BY PMEDEPARtNFNTOF LOCAL COVELMFA'T rfrA4t M41.1-rat
Gibson County Auditor PROPERTY OWNERS IMPORTANT NOTICE TO HOMESTEAD
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 nee for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1341-2000 requires axpasers 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 conlideruial 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 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Hammer, John D
3 Red Bank RD
Fort Branch IN 47648
_ _- _2598.
John D Hammer
3 Red Bank Rd State Parcel Number Lesal Description
FORT BRANCH IN 47648-1539
11111111D tlt�l11t 11tl�r11111rlltlrllrll lllrlt ll' uliittli 26-18-24-202-000.552-026/011-00552-00 PT NE 24-3-11 .50 AC
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
Cl r 66r) bA u/1 l gMN,t2
as-asst(rumba and strut.city,_tale,and LIP code) — — — __ _- —_ _ _ErSpm_e es property-ad.+..esc — -
Spouse First Middle Last
K 1r/4/ - L'AUR-CA thimine2
Mailing Address(Number and street,city,state,and ZIP code) I—I Scone as property address
-- -- - --
•
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 way be liable for back taxes and substantial financial penalties.
Owner 1 S czy/f---� Date
r
, •�`' CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� / State Fwm Sa73 (R6l d-03)
' Prescribed by tha Dapartmeni of Local Govemment Finance
� INSTRUCTIONS: See raverse side fir filing instn�ctions.
FORM
� HC10
� �
YEAR
5
-t'`..:w�.�t...,,#a' �..i.i�aEi+a�-.'^.Y,.tu����+:1�_.?'Y±.'�c:'.*��.,�'GERTIFIGA710N:STATEMENT�,-.--�.- -L
.. .. -: . a i . ..4 . x. _ :. .
� M�8) certify thaj� the 1st day of March, 20
I(We) ocap' as our prindpel place of residence the following described real property for which a Homestead PrMo�p�fiy T�c�raQ�Q�hereby Gaimed:
❑ I(We) owned ❑ Pre buying under contract '-
' Have e benefidal interest in Ne entiry Nat is liable for Ne pmperty texes on the proDertY and that owns the p o�ff�F isvayir� under a conVact.
If buying m conVSU, Fee Simple owners neme
Recordefs MMce whero contrap
Coun11'
On�� O�d" �� I L/ �/ /C.. �/" o� ��/ i�is N%Prol
It any portion ot Ne residential shuGure v the land not exceeding one (1) aae ihat immedWtey wrtwnds tnat
w me aoperry �nraed w proauca i�mme.
�:?}':3_"•`r,°�`.',�x+3aZ��'x''�.,�'�-'�:,Ty,t*°'^-�s��+'�-�tiPROPERTY.OWNED'� BY,:CLAIMAtJT.IN'OTHEft'
Caunty TwmshiD County
I hernby certify Ne above statements are We, correct end complete.
�ress (numDer arM sUeet ciry, atafa, ZIP oode)
Rewrd number � Pape
township)
al proparty ❑ MobOe Home Q.Q 6-1.7-7)
is used to produce I�oma, tlescribe Na usa and porlion
L_9�
Twvnship
Tk�� ��AS E SOR�USE;O�N Y�r�'"��� �;, �TRUE TAXt�`�� ASSESSED VALUE '� HOMESTE4D� �� b�� NON RESIDENTIAL`�, Z�'.
i':`�- ��?��`s�?�$I_� Z?�z _+.<^�`�`�.�+�� � � � - �AVALUEizy� v ATa100%OFrTiV� � �+.�` VALUE.��.�r� „��•. s��'�.+-VALUE�' ��i ^�.� `:
w s
t bn wYL � .'lXC...� i�,..l
Land not exceeding 1(one) acre�immediatey zi ;��;,.j� �,�-' y"�-.'f`-=x� -���
surtoundingresidentialimprovements. ��� �?,;.,_��Y3`'� ��<,�4a.f�x,,;s
rr ..
Other land (p� ` � h`-�� ' s �w
-a.r -
Ta[al land (Ilne 1 plus 1lne 2) (3�
Dwellin 4 ,-�:Ly �,`,.� S; ��'"� z f�''
Residenlia( improvements or Mnuaily 9 � � f� *"�r,.,.s'�-r" a�t�- �-� ; i�
Assessed Mobile / Manutactured Home -- "�s ��. v :� �. �,� �.�;�{,.r -z;
Garege �5� �.�s.�, , :� v �,t. «n
.. ,e'S�y.n ��,z `-• rw
i��
O�her improvements (6) �
Tctal improvements (line 4 through lirre 6) �7� .
Tdal value (line 3 plrs line � (g�
I hereby Certl(y the above is trUe, CorreCt, and � SignaNre of Pssessor Data signad
completa.
Verilyinp ection - Signawre oflwditw Date signed
1"k`"�7.��+'Y"� `..`.�_'{::L��..�„�t,� .�"a,'`�",� �STANDARD:UEDUCTION'ALiLOWANCE` -'�n� . ,;:.'�.,'. �� �+:=- -��•;:,..�' .
20_Pay20_
Lesser of 72 Homestead
Valuation or $35,000 5
SlgnaWre MPuditor Date signed