Homestead_Stephens (3)4 tin CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT/STANDARD DEDUCTION HC10
State Form 5473 IRS 110-01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
I (We) e,14 certify th i n the -IStrday,of-March,-20—G
I (We) occupied as oUr principal place offesidencei the folloking described real property for which a Homestead Property T Credit is hereby claimed,
I (We) owned El Are buying under contract 1 .1 M2
lave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the pro /� /7
perty or is buying under a contract.
r,�-CONTRACT RECORDED-;T!,§
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
A
K;!!) —.,
, ROPERTY. DESCRIPTION -
County
Township
,
Taxing district (city. 'A o
Parcel number 0
Legal description
dress (number and street, city, state, ZIP code) V
'(/-r CC-,oela�6 Z)—e-Tl Zf2 44
Is the property in question:
1
007—
Signature of Aud
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Real property ❑ Mobile Home (I.C. 61. 1-7)
If any portion of the residential structure or the land not exceeding one (I ) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
I.
P. R 0 P E FiW, bWN E CFBY CLAIMANT I N bT A E —`-` -- dOT I
4��,TRUE-TAXI',;.- ;�%V
County
Township
County
Township
I hereby certify the above statements are true, coff act and complete.
Signal &e of claimant
dress (number and street, city, state, ZIP code) V
'(/-r CC-,oela�6 Z)—e-Tl Zf2 44
'iAgSE§SOWUSE 6NLY:?!--Vi%
4��,TRUE-TAXI',;.- ;�%V
ASSESSEDMALUE
��.iHOMESTEADI:�
Vp�— , 4NON-,RESIDENTIAL:
Lesser of 112 Homestead
0 0 F TTV -
uation or $6.000
2
Land not exceeding 1 (one) acre immediately
Signature of Aud
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Date signed
04-12e2-
surrounding residential improvements.
Other land
(2)
Total land (line I plus fine 2)
(3)
Dwelling
(4)
ft2le,
-iV
Residential improvements
Garage
(5)
- - - - - -
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pits line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
,ISTANDARDI DEDUCTION ALLOWANCE',
�C �
20 _ Pay 20
Lesser of 112 Homestead
uation or $6.000
Signature of Aud
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Date signed
04-12e2-
STATE FOAM Mt.IR.r■AMI !MASI:LTA raaw 73.1A
•
ArrMwm or MATE MwRoor.Mn*L-r<.1%M rur_nmm or TIMr.DEPARTMENT(rt LOL,t1GOVERXMENT FD:ASCEW tl.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
`I more beneficial.there is more incentive than eser for homestead fraud.I Iomestead fraud causes higher tax bills for all:therefore.
'40 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 inforratmn necessary to allow county government to better monitor homestead
LE y Mintier.This information will he kepi conlidemial and can only lx•accessed by authorized county officials.The Depanment of
Local Government Finance will the this information to create tools that will help county officials eliminate homestead fraud.
PART I:PROPERTY INFORMATION
LU fU
NPR 1
Taxpayer Name Property Address
' Stephens, Gary R/Jennifer A
RI Box 174 A
O V, Oakland City IN 47660
3246 Gous1 Y FUOt�Q�
Gary R/Jennifer A Stephens
9159 E 550 S State Parcel Number Lezal Description
Oakland City IN 47660-8577
26-20-10-200- 01.736-001 001-01736-00 PT N NE 10 3 9 5.00 AC
1111111trtlllltttlleilltttlrrlttlrllltrrlltttl,Itirl,Itt,11,tl / D-8
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
Gar R S-t--e lie \S
fig Address(number and ,city,state,and ZIP code) .DI Same as props address
9t F 5 s o 6 06.106.4 Ci11-c.1 10 tAl1Q(eO
Spouse First Middle Last
Je.tkw-re. r A 52p Kt{k S
Mailing Address(Number and street city,state,and ZIP code) 1' Same as property address
SAS
•
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 eliuible 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 Sign n re Date
1