Homestead_Hurt (7) F • STATE FORM 53,410.t.Jnl MEASURER FORM:}IA
ArflUNED BY SINE.BOARD IM'4YYRMS.a1„ PACSRIDW BY no OFPARMf.YC OF LOCAL OOVEINxtrrrr FINANCE IC I.11.22.1.1
Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 InJividuaLS and married couples arc 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.h omesead fraud causes higher tax bills for all;therefore.
i • HEA 1347-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reecho the-
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kepi confidential and can only he accessed by authorized county officials.The Ikpanmenl of
Local Government Finance"ill tor this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Properly Address
_ Hurt, Kathy G
402 S Willard
Fort Branch IN 47648
7834
Kathy G Hurt
402 S Willard State Parcel Number Lesal Description
Fort Branch IN 47648-1660
I t t�n��n�tu r��t��n t��n��nt��rtrtt�t�t��nl 26-19-19-101-000.348-026 011-00348-00 EASTVIEW 19
in��nt�t��n
PART 2:TAXPAYER INFORMATION
Owner I t^� 11•• First Middle __,�_}{ Last
g Address(number and street.city,state,and ZIP code) j-Same as property address- ' —. —. --
402 Sou \ U1/45■ (aig._A V V . a&at,JOCflJ Lf- w0$- 1 (0100
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) 0 Same as property address
Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) Other(plctie specify in Part 4 below)
sere
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
unlawfidly,he or she may be liable for back taxes and substantial financial penalties.
Owner 1 Signature late
•
� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Sute Fortn 5473 (R6 / 4-03)
Prescri6ed by the Department of Local Govemmenl Finance
INSTRUCTIONS: See ievcrse side (or /iling ins��uclions.
FORM
HC10
YEAR
� M�e) �un tMe 1st day,oi �rch, 20
I(We) occupied as our prindpal place of residen e following described real pmpe for whid� a Homesle P pYrty lTac -Credil is,haeby aimed
❑ I(We) owned ❑ Are buying under act �/ ry
�Have a benefidal interesl in the entity that is Gable for the property Wxes on the property and ihat owns the property br is btlyi�er a contrad.
If buyirg om m�traG, Fee Simple owners name
Recordels ofice whera mnVaq is recorded
Counry
Tamship
Tating disirid (nN.
Record number � Page
Par�Wnb�r "„ --�,l� ` ILegalde5criptqn'�i/�l�I;/` / _ �// Ils�hepmperty�ip.qu� :
/ y �•{ \l., .../ A 1 /" rF7 N n 1
1 _'lilN I �-l�/ ( / (/ LY/-t/ 7 ��- �o�m ❑ �7oWa Homa (l.C. 6f.7-�.
H arry portion ol the residenUel strucNre w Ne lantl not meceeding me (1) acre ihal immeEiatey wrrounds Ihat swcWre is used b produce inoome, desfribe Me use and pwtbn
ot Ne propery uLT¢ed W Drotluce i�ome.