Homestead_Brown (4) •r - ' IlVE FOISt NwIR:/fell nulnueLR FOAM TSIA
Vrinfn nT'rutnMDnArrOIs'rt,wrl rtf3mamaY nlr DEPARIo.TOEL0.LL f tMMIAT fp:ANCEIC-tI-L`r.l
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 eser for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
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 information nece:a'Try to allow county government to better monitor homestead
filings.this information will he kept confidential and can only he accessed by authnriaed county officials.The Department of
Local Government Finance will use this information to create tools thai will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
Brown, Theodore G/Michelle T
R3 Box 326-j
Haubstadt IN 47639 /
3436 11,((J ii
Theodore G/Michelle T Brown iVi
251E Hirsch Woods Lane State Parcel Number Legal Description
Haubstadl IN 47639-8831
lrlltllttrltllrtttlltlilttlttltittltttlltttllltltltdltlltltltl 26-23-07-200-000.487-024 004-00487-00HIRSCHLAKEESTATES4
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 to
Owner I First Middle Last
1)0 CT -- gow.I�
�lc Address(number and sum,city,state,and ZIP code) Same as property address
2 s 1 6 I-1 izSC4 wooer c N) _ 14AU&S'nl-eir IN 0 1(03°/
Spouse First Middle Last
pi ckel\e -i ` mown
Mailin:.Address(Number and street,city,state,and ZIP code) D Sane as properly address
-)& vin e_
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 o may be liable for hack taxes and substantial financial penalties.
Owner I Signature • Date '
ee • . vi- ddress of - 3zfo — was c in.a.'me d
-to Z1� 1 I-f IrScti NeJa oclS L-vt by e Gi hSor,
Coo y+y SHcccet Far e —9i, Acidress.v j.
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2 / S92)
FORM
HC10
YEAR
�U3%
INSTRUCTIONS: See reverse side lor filing instructions. 'T '��� � T' t
t�
CERTIFICATION STATEMENT
I (VJe) certi�y�t6n�a�ls��yf March, 79_
I(VJe) occupied as our principal place of residence the following descnbed real property for which a Homestead �Property Tax C�� is her�by claimed:
i
❑ I(VJe) owned ❑ Are buying under contract ...�� ;,. �� s�
❑ Have a beneficial interest in the entiry that is liable for the property taxes on the property and thai owns th�op€�ty orisbuying�ur�dg , contract.
CONTRACTRECORDED -
If buying on cronvact, Fee Simple owners name
Recortlers oHice where convact is recorded Fecord number Page
PROPERTY DESCRIPTION
Coun Tawnship T ng tlis - 'ry town, ro ip)
arce num r Leqal tlescriptio
�
If any poNon ol Ne rcvden6al sWCNre or Ne land not ce ing one (1) acre that immetliatey surtountls that swcture is usetl m produce income, describe Ne use and ponion of
the property util¢ed to produce income.
-�3-a% vo-� -oa
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township CAUnry Township
Si nat ai n
ereby certify the above statements are true, correct and complete.
Addre (num6ei�ntl gtreel, ciry, stat� code) . / , / �� / /� ����� .
/C J�� s TAC_ c� r8 %� iii�ce�
ASSESSOH USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
� VALUE VAWE VALUE VALUE
Land not exceeding 1(one) acre immediatety (»
surrounding residential improvements.
Other land (2)
Total land (line 1 plus line 2) (3)
Dwelling (4)
Resideniial improvements
Garage (5) I
Other improvements (6)
Total improvemenis (line 4 through line 6) (7)
Total value (line 3 plus line 7J (8)
1 hereby certify the above is true, correct, and Signature of Assewr Date signed
complete.
Verifying ac6an - Signature oi Autliror Date signetl
� STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of t/2 Homestead S
, Valuation or 52,000
Sig at o uditar Dat si ned
Y �aa-