Homestead_Asay tI ATE FORM Me.(R.:r YMI TPfASUUE3 FOP-4 ZIA
APPRCEO BY Ctk7E BCP.RD OF AnM 4+TS_`uni PFry(mnI'D BY TlIr DEPARTMENT OF uxALnOVERNMrK,FTsMCEMVI.I3:.1.1
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 bemires
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 taspaven who receive the homestead standard deduction to verify that they are eligible to reecho the
benefit and to provide additional identifying information necesnry 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 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Asay, Donald F/Linda S
10519 S Oakridge Estates
(laubstadt IN 47639
10761
Donald F/Linda S Asay
10819 S Oakridge Estates State Parcel Number Le2a1 Description
Haubstadt IN 47639-7860
Milli l..'1..1 1 1 1 1 1 1.1.1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I l l i i i i I I r r r i 26-23-02-400-001.713-024 004-01713-00 PT w E 2 4 10 4.00 AC
X D-10
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
7 �S
4_[4 a`/
�g Address(number and street,city,state,and ZIP code) - - _- -- - Same n y od
c propertdre s ---
- -— -
1021 I Sawf., Oat I'L nie2yt Esfkci
Spouse First Middle Last
I--► KdCC. Sue-, >¢s
Mailing Address(Number and saee4 city,state,and ZIP code) 3.a Same as property address
111 5-04 , Oett_i ..leele, Esfe-es
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.
Owner I Sigture
/Cq a f�^ G �/ Date
Li eZf/O
•
•
e��'n
°. CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
y��r CREDIT/STANDARD DEDUCTION HC10
��' State Form Sd73 (R2 / 5-92)
�si.
INSTRUCTIONS: See reverse side Ior tiling instructions.
I�We) ��1 [.U\ :� �- 1 n certify ihat on �st�aSof�A�h; 79
�:) occupied as our principal place ot residence ihe following describ d real property for which a Homestead Property Tax Credit is hereby Gaimed:
❑ I(We) owned ❑ Are buying under contraci
❑ Have a beneficial interesi in the eniity that is liable for the property taxes on the property and that owns the a t.
gig^pn Ct.4) . �.Jf�l
� - � � - CONTRACT RECORDED � � � -
It Wying on contraa. Fee Simple ownefs name � -
Recorder's oflice where coniract is recorded Record number Page
Township
DESCRIPTION �
Tax� distnct (ciry, fown, township)
Parcel number Legal ion
�c�o c � � 3-00 '�+ t,� � a � ► c� � �4 c
It any ponion of the resitlential sWCWre or the land not exceeding one (7) aae that immediatety surrountls that sVUCture is usea to protluce income, tlescribe �he use antl portion
of ihe property utilizetl m protluce income.
Caunry
- �.� -
PF
Township
-'f"QO-06�. `
'Y OWNED BV ClA1MANT
Counry
certify the above statemenis are true, correct and complete.
s(reet ciry, sfaie. ZlPOOde)
�. ir✓ c—'Yi —
COUNTIES
claimant
Township
ASSESSOR USE ONLY . TAUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding i(one) acre immediately
surrounding residentiai improvements. (�) �
Otherland (p)
Total land (line 7 plus line7� �3)
Dwelling (4) - •
flesidential improvemenis . .
Garage (5� _ '_
Oiher improvements (6) ��
Tolal improvemen[s (line 4 through line � (7)
Total value (line 3 pbs line 7� (g) _
I hereby certify the above i5 tme, correCt, and Signature of Assessor Date sgned
complete.
�ying aaion - SynaWre of Auditor � Date signed
19_Pay19_
Lesser of 1l2 Homestead
Valuation or 52.000
Autlimr
STANDARD DEDUCTION
S
Date
-as 9