Homestead_Jones (7) STATE FO&M MN.1R_I•NI iPE151:EER RAW 11A
ArPRIT'Ef BY ST CIE WARD Of Arn7JNfl.20N PEFYRItFD BY 111E DEPARTMENT OF L(MtALO0EF.YMFN7 FINANCE IC -t.1-"4,I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and flurried 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 tat bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to receive the
benefit and to prtwide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only he accessed by authorized enmity officials.The Ikpannhent 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
_ Jones, Terry L/ Evelyn F
k?Box 63
t IN 47639
10739
•
Terry L/Evelyn F Jones
10564 S 350E State Parcel Number Legal Description
Haubstadt IN 47639-7869
26-23-02-100-000.569-024
1I1Ir11tr t1rilttr tlltltlt t�t ttllttirtllt rit itt tlltrtlttit ttill 004-00569-00 PTw 24103.00 AG
X
.
Spouse First Middle Last
EVE Lyv FRyE JONES
Mailing Address(Number and street,city,state,and ZIP code) 'Same as property address
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 Signature Date
rt.�•n
aa �`, CLAIM FOR HOMESTEAD PROPERTY TAX
_��� CREDIT/STANDARD DEDUCTION "
„�i�,,;�� State Porm 5473 (R2 / 5-92)
�u7
INSTRUCTIONS: See reve�se side /orliling inst�uctions.
FORM
HC10
��� Atl'1�
YEAR
1(We) _(-�
place of residenceQe tollowing de ribed reatproperty for which a Ho tead Prope Ta redit is re Gaimed:
I(We) owned ❑ Are buying under contract
� Y P P Y P P Y GIR�O P OU TY nyJ 91T0�
❑ Have a beneficial interest in the eniii thai is liable for the ro ert taxes on ihe m ert and that owns the ro ert or is bu in un er a contract.
- � CONTRACTRECORDED � �
If buying on contract, Pee Simple owner's name . _
Recortler's ottice where crontraa is recorded Rewrd number Page
� PROPERTY DESCflIPTION
County. � Township Taxing distria (ciry, fown, rownshrp)=
Partel number Legal deurip�ion
�4- - r� a- _
It any portion ot the resNentiai strucmre or the lantl not ezceeding one p) acre ihai immetliately wrrountls that strucWre is usetl m protluce income, tlescribe the use and portion
of the property uulized to produce income.
. . . � - . . i '� � � � ..
- v�s�
PROPERTY OWNED BV CLAIMANT IN OTHER COUNTIES �
Counry Township Counry TownShip
�reby certify the above statements are true. correct and complete. Signawre � iaiman�
Atltlress (numberantlslreet, dty. sfate, ZlPCOde)
ASSESSOR USE ONLY TFUE TAX ASSESSED HOMESTEAD NON•RESIDENTIAL
VALUE VALUE- VALUE . VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvements. (�)
Other land (p)
Total land (line 1 plus line Z� (3�
Owelling (4)
Residential improvemenis
Garage (5)
Oiher improvemenis (6)
Total improvements (line 4 through lina � (7) (
Total value (line 3 p�s line � (g)
I hereby certify ihe above i5 ime, CorreCt, and Signature of Assessor Date signed
complete.
Veritying action - Signa;ure ot Auditor Dare s"gned
19_Pay19_
Lesser of 1/2 Homestead
Valvation or 52.000
S
ALLOWANCE
— �_