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Homestead_Glowatcky 57.3.1£FORM.\MIRE/410 !PrASuRCR FORM 73-tA APPROVED BY STATE MYRE CIF NM1Rmts.•Fn PVSNPtDa•171E DFPARr Yr OF LR• L GOVERNMENT m:ANCE M•-f.13224.1 Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and married couples arc limited to one homestead sandani deduction.As the receipt of this deduction becomes more beneficial,there is more incentive than es er for homestead fraud.Ilomestead fraud causes higher tat bills for all:therefore. 40 HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reecho the benefit and to provide additional identifying information necr star'to allow county government to better monitor homestead filings.This information will he kept conlidential and can only be accessed by authorized county officials.The l)epanment of Local Government Finance will use this information to create touts that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION — Taxpayer Name Property Address Glowatcky, Ronald K — 115865150W llaubstadt IN 47639 3349 Ronald K Glowatcky 11586 S150 W State Parcel Number Legal Description HAUBSTADT IN 47639-8753 IlltrlltttlllittttllllllttlttllltttlEllltttlilittltrlltttittll 26-22-12-300-001 9997-024 004-01997-0o PT W SW 124 11 1.50 AC 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 Owner JJI�� First / Middle Last (� OMACD CC 41_0 h.✓ArceEy 4,ng Address(number and street.city,state,and ZIP code) ©'Same as property address // 586 S / So w Spouse First Middle Last BREA/DA L 6 c w,4rcfcy Mailing Address(Number and street,ciy,state,and ZIP code) f4me as property address - -- - -- . PART 3:CERTIFICATION Each undersigned certifies,under penalty of perjuy,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. Own 1 Signature �� Dal- - �} CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION �� Siate Fortn 5473 (RB / 4-03j Presaibed by Ihe Department ot Local Govemmen� Finance INSTRUCTIONS: See revcrse side /or liling instrucfions. � FORMT '� �� YEAR 11�Hi�p1LJ.L� SEN ,� a 2003 I(We) �C.� certi(y ihaf'�o'n the�lst�dsy of MardiT2tl� � I(We) occupied as our principal place oi residen he following described real property (or which a Homestead Property Tac Credit is hereby daimed: �I (We) owned ❑ Are buying under contract , Have a benefidal interest in the entity thal is liable for ihe property taxes on the property and that owns the property or is buying under a conUaU. If buying on conVad, Fee Simple ownefs name Remrders olfice where contraIX is recor0e0 Couny Parcel the �o�-o��c��c -�a�--Nw 5W ia-y-i� �.-sak. H any poAian of Ne residential sW cWre ar Ne land not exceeding one (1 � acre lhat immediately surtounds of the ptoperty u�7¢eO b produce income. Rewrd number � Page lownship) al property ❑ A7oMle Homa (I.C. 6f.1-� is used to produce income, descnbe Ne use antl portion / a..:sw,. � $�AS.�SESSOR OS ON Y����''� �` TRUETAXT� �ASSESSED�VALUE �+HOAAESTEAD z� F NON ESIDENTIAL ��`+ ,E�",iy'.t ����'a^CF�:�,.���"��'�,...' . e VALUEx..s�??- y.,ATa100°h..OF,TTY S,�' z VALUE���'S ���'�"[."$°VALUEz-v�.�"��: Land not exceeding 1(one) aae immediatety r'�`�y�-�'��zY*�r��`�:�,,� surtoundin residenUalim rovements. (�) � '� +b%- v 9 P .,�;�_..��..�.�.'?a�."..��.��.,,�'���.=� Otherland z *S �;.: (Z) ��=--� Tdal land (line 1 plus line 2) (g) Dwellin ����"# ��'������ ResidentiellmprovementswMnually 9 (4) �°'�'�°�''"""�"��� AsSe�ed �1ob0e / �lanufadured Hane �' ,�: �-� s Garage (5) �„���' .g. •�� �� � c ��y�� � Other improvemenls (6) �s. � ��� Tdal improvements (line 4lhrough line 6) �7� T�tal value (line 3 phs line n (g) I hereby certi(y ihe above is W e, corred, and Signature otwssessor Date sgned complete. Vetilying attion - Signature oflwdibr Date signetl ���..��.,'�,4`"_`�-�-�?�����sTiwonROOeoucnoN�auownrice�^�',�,�ue .��i�'�.�.-�`�a°-_��*,����.�-���,� 20 _ Pay 20 _ Lesser o11Y2 Homestead Vauanon a E35.000 S � Sgnature of Date signed � R-�1-�