Homestead_Long •,
STATE FORM 9300(U/9-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.X09 IRETCI1BLD BY THE DEPARTMENT OF LICALCOVEL'MEYT FTA41E IC 6-1.1-IIdl
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N.Main Street Individuals and married couples are limited to one homestead standartededuction.As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever 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 necessary to allow county government to better monitor homestead ,
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
1' [.oar Government Finance will use this informati ffi
on to create tools that will help county officials eliminate homestead fraud.
PART L: PROPERTY INFORMATION
APR 2 9 2011 Taxpayer Name Location Address
Long, David R/Katherine M
_
Cl. ` / 10791 S OAK RIDGE EST
11210CIBSON COUNTY Y /X\
VV HAUBSTADT IN 47639
AUDITOR
IIOIII�IIIII.III_ llIIfIIH I 1E1l ILIIIII JIDIIII11111 IIIII Da idRLong
10791 S Oak Ridge Est
HAUBSTADT IN 47639-7863
IIIIFiIIIIIFFI11'IIIF IIIIIIIF IIIII'IIIIIIIIIIIIIFIIII"iIIIII'III State Parcel Number Legal Description
26-23-02-200-001.993-024/OAKRIDGE EST 14/15
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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.
i lam I •
O,, _ I - First Middle Last —
6 4w`d gss Loos
Mailing Address(number and street,city,state,and ZIP code) g Same as property address
10 Tit 5, 04 Q:d►g esE //4.4L(/CJ/, TN '7625 -
-
Spouse First �M Middle / Last
`r - Ilse ► ' ce I �- /��I``G'a/J
Mailing Address(Number and street,city,state,and ZIP c e) Same as property address
iet 14 ( 5 ojt e 2ast S ` �
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 ay be liable for back taxes and substantial financial penalties.
Owner 1 Signa Date
rt,} CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
j Slate Fwm 5473 (R6I403)
Prescribed by the Department ot Local Govemment Finance
INSTRUCTIONS: See revc�se side 7or lilinq inslniclmns.
FORM
HC10
�( �
YEAR
��e) �`. �� l,1 �� ' �U , 1 certi t n,the,1 s!)d��a�v��° f March. 20
�I(W,ee) oaupied as our puncipa� f residence ihe fWlovring des b de al property for ' a Homestead Pr�erty�T� (,Yc'dR Is hereby daimed:
L71 (VJe) owned ❑ Are buying under contract i� � `f
—� / �
,P Have a benefidal interest in the entity Nat is liable (or the property taxes on the property and Ihat owiistheproperty or istiuying under.a contract.
If buying on contraq, Fee Simple owners name
Rem�ders ofice where wntraa is recorded
CaunTy
Tavnship
(d1y, fown, township)
Remrd number � Page
Parcel number Legal description Is Ihe pmpeny in questian:
�� � �`� ��" ❑ Real Droperty ❑ Mobile Homo (I C 67 1-n
H any poM1ion ol lhe residentlal sWCWre w Na land not exceeEing one (7 � aae that immediatey wrrounds thal sWCture is used b D�uce income, describe the use antl portion
ot Ihe property uUlized lo produce income.
�a'G - a 3 - oa-�Qo -�/ 99.3-oa5`
Tavnship
I hereby cerG(y ihe above statements are W e, correcl and complele.
Address
�2
s(ate, ZlPcrode)
Couniy
20 _ Pay 20 _
Lesserof t/2 Homestead
vauauon w E35.000
�
Date signed
1 . �1 / �
; � ��-. . _ .._.