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Homestead_Everett • MATE FORM R35*IR:I mITI TREASURER FORM TSIA VFRrREO DT 511E MNRO Of MR nn5TS_!NN PRISCRInm BY ear OMR-MENTOR tOcm.GOVERNMENT FP:AscE It trl.l-DR.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 tandarl deduction.As the receipt of this deduction becomes more beneficial,there is more incentive than ner 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 recent the ® benefit and to provide additional identifying informaton necessan'to allow county government to better monitor homestead tiling.this information will be kept conlidential and©n only R arceonl by authorized county officials.The Ikpanment 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 Everett, Susan K RI Box 1261 Haubstadt IN 47639-9750 9573 Susan K Everett 12501 S Scottsdale Dr State Parcel Number Legal Description Haubstadt IN 47639-8679 26-22-14-300-000.475-024 004-00475-00 SCOTTSDALE ACRES 1.96 t o II sot III rat II t I r I n'n I n II nI or stIII n II (III nt I AC 0-2 PART 2:TAXPAYER INFORMATION Owner I First Middle Last Sv sQTA K. were (( g Address(number and street.city,state,and ZIP code) © Same as property address - - • 125.0( S SCa{tcj4(c )--)r. i Igor*-e5 tc(1 , LAI 4(7<p3, Spouse That Middle Last Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below) sae 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. Own Signature Date • y� CLAIM FOR HOMESTEAD PROPERTY TAX i� �� CREDIT/STANDARD DEDUCTION State form 5473 (R2 / 5-92) 's�! INSTRUCTIONS: See reverse side lor Iiling instructions. . .. . . . . . - . � . � j . - - "'-.:.CEETIFICATI FORM HC10 YEAR I: We /1^ _ U L ceni t/t�{a�e t ehq sf7�y�q.. f�March, 19 �( Ve) occupied as our principel place of residence the following described real property for which a Homestead Prdpe�rty �aKCrEEIf� hereby daimed: I(We) owned ❑ Are buying under contract � � (//� ❑ Have a beneficial interest in the entiry that is liable for the property taxes on ihe property and thai o or5s zEontract. ��i;NTY h DITOR 1 " � � � - -- .,.CONTRACTRECORDED.:< ., - ' If buying on contrad. Fee Simple owner's name Recortlefs oNice where coniract is recordetl Record number Page . . - , . . . .PROPERTY DESCRIPTION . - � e;� � � '- .-: � °,V:.. Counry Township Taxinq tlistria (dry, 1 n, t Par I n m er O `� Leqal description ( If any ponion of Ihe resitlential strudure or the land not ezceeding one (t) acre that immediarely wrrounds that swc[ure is used to produce inwme, describe of ihe properry utilized to produce income. - o�o� - i • - c�<�u - PROPERTY OWNED BY � Tawnship certify Ihe above siatements are irue, correct and complete. � number a� svee(, ciry. srare, ZIP wde) / '.l. L�a.r .l ZG -?� /�a.._�s7'a.� ASSESSOR USE ONLY Land not exceeding 1(one) acre immediately surrounding residential improvemenis. Otherland Total land (line 7 plus line Z� Dwelling Residential improvements Gara9e Oiher improvemenis Total improvements (line 4 fhrough line 67 Total value (line 3 p�s line � I hereby certity the above is true, correct, and complete. Venivim action - Sionature of Audimr 19_Pay79_ Lesser of 7/2 Homestead Valuation or 52,000 Sgnature of Autliror TRUE TAX VALUE (�) (2) (3) (4) (5) (6) (�) I8) olASSessor S '. �S-l�o?/`� YT IN OTHER COUNTIES�. nty i fclaimant � � _ .G �l".a �•v �f�� 3 % ASSESSED HOMESTEAD VALUE VAIUE a r oi' Ne use arid pohion NON-RESIDENTIAL. _ VALUE Da;e signed Date s"gned Date s�g � /��