Homestead_TollCLAIM FOR HOMESTEAD PROPERTY TAX FORM YE A
CREDIT/STANDARD DEDUCTION HC10
State Form 5473 IRS 110-01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
.'CERTIFICATION STATEMENT-%
-PROPERTY DESCR14
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1 (We) ru try arch, 20
certify' on
I (We) occupied as our principal place of residence the following described real property for which a Homesteadguyny, Tax TH s hereby claimed:
El l(We)owned El Are buying under contract
Have a beneficial interest in the entity that is liable for the property taxes on the property and that ofhe is- ying u9der contract.
�proejor
I* -Z,
GIBSON COUNTS AUDITOR
If any portion of the residential structure or the land noflLtxceedingtfie (1) surrounds that structure is used to produce income, describe the use and potion
of the property utilized to produce income.
CO NT RACT! RECO RD ED
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded
Record number
Page
N ...... 'A-IT �PROPEkTY-.61NNEbBYCGkIMANTIN OTHER 'COUNTIES ,�
-PROPERTY DESCR14
Co
Toomship
Taxing di
'cry, town, l unship)
Parcel number
OD C0339 -0D IVUE7-3-5
I d �tion
1-7-45Ac
is the property in question:
Nl�l property ❑ Mobile Homo (I. C, 6-1.1-7)
If any portion of the residential structure or the land noflLtxceedingtfie (1) surrounds that structure is used to produce income, describe the use and potion
of the property utilized to produce income.
N ...... 'A-IT �PROPEkTY-.61NNEbBYCGkIMANTIN OTHER 'COUNTIES ,�
County
I Township
County
--1711;
nship
I hereby certify the above statements are true, correct and complete.
Si natur of I cz��W
gaid,r4ss (number ZIP code)
XZ1
ASSESSOR USE ONLY�—;- -
.-!-'.TRUE -TAX 1,
ASSESSED VALUE
',�T.1000�6
- -
'VALUEC't-'!'
r,�NOWRESIDENTIAJ
VALUE:.;_-' -;
OFTTV-
ZX�LVALUE�',3�
.'
Land not exceeding I (one) acre immediately
W
surrounding residential improvements.
Other land
(2)
Total land (fine I plus line 2)
(3)
Dwelling
0-0
(4)
Residential improvements
Garage
(5)
-----------
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus 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
TANDARD.DEDUCTION ALLOWANCE t
1W 20 _ Pay 20
Lesser of 1!2 Homestead
Valuation or $6,000
Sig ure of Audha Date d
SIAM IDRY•3,.t1t:r• l IRIASUaEA FORM 73-IA
APrMn'ED By SI OE BROOM arrob'r%.:n• PRESCRIBED BY TIM DEPARIAerTsr LOCAL OlIVZRYMENT FC CE M•1.1-L4.I
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 ever for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
® HEA 1344-2000 requires 1a:payers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying inform:nwn necessary ro allow county government to better monitor homestead
filings.This information will he kepi confidential and can only he accessed by authorized county officials.The Depannlent 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
Toll, Richard M/Cindy R
1202 W Buena Vista Road
Evansville IN 47710
8537 , V/,
Richard M Toll
R1 Box 335 A State Parcel Number Legal Description
FRANCISCO IN 47649-9152
Itltl'Ittllrllrrtltlllt lrrl1111111 l'rl llrrrl tl ill tlrrrllltrltl 26-20-07-200-000.339-001 001-00339-00 PT NE 73932.56 AC
D10
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PART 2:TAXPAYER INFORMATION
Owner I First Middle Last'
�g Address(number and street.city.state,and ZIP code) l 7t 1 mitre as properly address '- -
S 7 'ci C: Act) 6
/
Spo First Middle Last
C/� fAC / O(
Mailing Address( umber and street,city,state.and ZIP-=ode) I Same as property address
S 7(7/ C. bn, e
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
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owns Bat Date
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