Homestead_Luigs iI\II IOR∎IS 4,R!/,l61 IR`AORLA NAM ISIA
APPROVED BY 1%7E aO'Rf.OF Al 1,,1 NT i.J•R 114.50JNYD In Tn:OEPAR!MEsr OY LOCAL CmtR.\s1L'r sr'&sri Ice.-:.1_'-+t '
Gibson County Auditor . IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS..
101 N. Main Street Individuals and married couple.. ale limited to one homestead statulud deduction.As the receipt of:hi. deduction become.
Princeton, IN 47670 more beneficial.there is more irccntise than ever for honrstcrad fraud.Homestead fraud causes higher my bills liar all:therefor_.
0 OEA 1344-209 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to lecei'e 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
Local Government Finance nill use this information to creme tool:that %sill help county officials eliminate homestead baud.
PART I:PROPERTY INFORMATION-
- SEP 5 2012 Taxpayer Name Location Address
C ,� Luigs, David A/Dawna K
2299 E PRESLEY LANE
GIBSON COUNTY AUDITOR HAUBSTADT IN 47639
11198
David ALuigs il_IHIII_fill1n111miliiiEli1_DIIIniniiniinfluniiiii�iEliuu_II_II.11nnlllll-Iil]II ll
2299 E Presley Drive
HAUBSTADT IN 47639-7968
'IIIIIIII 111'I'11'I'111'I"11111IIIttll'�1111'11'llllllllll'll'I State Parcel Number Legal Description
26-23-16-200-002.040-024 COUNTRY AYRE EST 13 .
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: .
.ter I First Middle Last
--_ -
) kit_C� 1 U'S5
Mailing Address(number and street.city,state,and ZIP code)) 0 Same as property address
�9`1 •,restP-e-� <-�J e-w-c- 1&u eC hi 47 b 3 7
Spouse First \� Middle Last
�iwh� s
Mailing Address(Number and s:roet,city,state.and ZIP code) Same as pmperty�drcss
2.2-99 E.-Vie-esle-Li - a>.),6�si--ac>.�- Wlllu 'f71p3 �)a — _ _-
- - -
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
CLAIM FOR HOMESTEAD PROPERTY TAX
- CREDIT/STANDARD DEDUCTION
t / StaU Fortn 5473 (RS / 16-07 )
ua PrestriDed �he De
by partmeM of Local Govemment Fina�xe
INSTRUCTIONS: See 2verse side /or filing instructions.
FORM YEAR
HC10
� �
�
I(We) certiry at on the tsl ay o March,/20 //�
i_(-�
I(We) occupied as our principal place oi residence the followi descnbed real property for which a Homestead o rty T�it�s�ereby�afrnEd:
❑ I(VJe) owned ❑ Are buying under conirad '�N CJOUt:TY� AUDI70R �
`Have a benefidal interest in the entity fhat is liable for the property taxes on the property and �hal owns the property or is buying under a wntrad.
If buying on coniraci, Fee Simple owners name
W / ' I
H any ponion of
ot the proparty i
contraa ia recorded
Tumship
' / Legal descriptbn
�G �f-G-l/
�� me
tawn,
utlantlal strucWre ar Ne land not eYCeedinp ona (1) acra ihet immeCiataiy wrrounds that si
N P�uce i�ome. � �. / /
��S -0�.3 �� - o7C8 -1�0�. O �`D- Oo? T
Record number � Page
Real Droperty ❑ hbbile HomBII.C. 61.1-7) -
ve is used to produce incane, Oesaibe Na uee end portion
�'L�_ bt . ..� .'� . . .- ' i = - uP_:` �h 4 V[a �
��- „_���s�-r�,����`�STANDARD:DEDUCTIONqLLOWANCE; �-� f�?""^�' `
oa., : � . `'`�a-t�.�a� - i-"�'DI���*'�.��?� � j-.'?<
. . _ _... __. _ . .. . _. . �.
20 _ Pay 20 _
Lesser of 1/2 Homestead
Valuadon or $6,000 $
SignaWreolPudita � Datesigned