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Homestead_Friedman ' STATE FORM 53N.iR=1 H•1 TREASURLR}ORM TS-IA .ArfrIW ED BYtt1TE INIARD OF ACM NTS,9v EREYAJBCW BY TT DEPMflEYTOF 1U L Cw'ER.YMt%l FINANCE IC II.I-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. 0 HEA 1347-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receve the benefit and to provide additional identifying information necessary to allow county govemttlent to better monitor homestead filinth.This information will he kepi confidential and can only be accessed by authorized courtly officials.The Department of Local Government Finance will use this information to create tools that will help canny officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name uperty Address A+• Friedman, Randall J 11509 g r`oo Kv to u Haubstadl IN 47639 10922 Randall J Friedman P O BOX 152 State Parcel Number Legal Description HAUBSTADT IN 47639-0152 Iti �� t�r��nnl�t�t�Il m �� I�11 �t�1111n Ilt�t��t t� 26-23-11-200-002.115-024 Whispering Winds Sec 3 Lots 24/25 u n X PART 2:TAXPAYER INFORMATION Owner I First Middle Last � Nox Toy FAT E ,LoM ,-n/ �g Address(number and street.city,state,and ZIP code) - - — Sums ns propcny addreas - ---P,-0 , 13 O X l 5 . 1-t A-o ssT.410 i Z r/I 4 .'1-62 3 9 Spouse First 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) • see - 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 ignanue Date • (�� CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR CREDIT/STANDARD DEDUCTION HC10 � S�a�e Fwm 5673 (R6 / 4-03) Prescnbed by �he Department ol Local Govemment Finance _� � '(��"`�{ INSTRUCTIONS: See revcrsc side loi liling inslrucGons. Ti ��' � li L! �l►� �SJ �`�n'-_'.��Y.:�'!��;, v�'"_�'''>`-'-�'�`�r��-� z`-'c."=��` s.:CER ICATtON STATEMENT.v..Si`F' �+�r-�,�,�.,, ��ti; _3^i7 z• -�'.tiM.. -.^- - .r--s.F�:�-.7.._. :�e. ..rr�:e�°�t�'y'..x?!17,� ;+.�'. I(YVe) F E D�� erti{y �at on the 7 st day of March, 20_ I(We) occupi as our principal place oi re ' ence Ihe following described real property.(or which a Homestead Property Tac Credit is hereby daimed: ❑ I (We) owned ❑ Me buyirg under contract �/ --,�, � - .�. - y �.c � Have a benefidal interest in the entity ihat is liable for ihe properry taxes on the prope�ty,and that owns fhe property or is buying under a wnVaU. I( buyiny om m�iraq, Fee Simple owners name Recorders ofice where coniraq is recorded Record number Page ,�<c�,z.��=.�.��.1 ",- ' _ �."'_' . -� -- � - - - - a �d', "t?F._r- u ,v�c.,zy '� -�.v•��th,.?��:x :� _`�.-��r-�� v�'�``��`r�`+�"m��.''r,�._�a"�a �P,ROPERT,Y.OESCRIP,TION�t.. �,�-. }r� .t�, ,�.-, „�,,...,x c..��, County Tpmship Tating tliStriU (crry, town, township) �l J� �� W I ��9a/ �/ p \ ^� I Is ihe ProPertY in question: lJ (�t,j Vl ❑ Real properry ❑ Mob�e Hwno Q C 61 1-� If any poNOn of the residential sWCWre ar the land not excaeAing one (1) ave that immetliatey surrounds ihat swaure is used to protluce income. descnbe the use and poNOn W the proD�Y utilized m produce inmme. L� �� EONiy.a'��`�-� �TRUETAX� � ASSESSED�VALUE �HOMESTEAD r` NON-RESIOENTL4L Y � x > _':i'�� iz'aE'z�rxi`�;.�"a_`t:�'�r�'1`.� ^..'.�ia�'.sc-d`4�i"�„�''. ��'iVALUE� `+,t '�;AT 700%�.OF�TfV� ��r�NALUE `.�c ��?'u.VALUE ��i�� Land nol exceeding 1(one) acre immedialety ��) 4�� 'r�� x3•i� surtounding residential improvements. r�y�� . si P�x��, �_, Otherland . a� �.-'�.�� .4 IZ) �- ..�-�.: Total land (line 7 plus line 2) (3) Dweliin9 ( ) ,'�� .yt �� .:�;� -�.^ Ei , : n-. _ . f:+q 4 ��.��lTi.�..al•�J �.'' ..�'' �`JC�:�` Residentiel improvements or MnuaDy - 0.ssessed Modle / Manufac4ued Hmre Garage (5) ��: .�� v� ��; _ � Otherimprovements (6) ,�.,`F,; � LE�`i4�4�it.Y� Tdal improvements (line 4 through line 6) (7) Tdal value (line 3 phs line � (g) � 1 hereby certify the above is W e, covect, and Sgnamre ofnssessor Date signed complete. Velirying action - Sig�Wre olAuditor Date signed