Homestead_Malone , SIAIE IOV10'm,EIs.d IPFASU[ER MP:CS-IA
APPROVED BY STATE MiRDOrvrrEslAain Par9[WWD BY TIE DEPARTWpr Of LOCAL CA ERNMEFT,EAFCE IC 4-1.I-1:4I
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 ever for homestead fraud Homestead fraud causes higher vas bills for all:therefore.
• HEA 134-3-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receue the
benefit and to provide additional identifying information necesss n'to allow county government to better monitor homestead
filing.This information will be kepi conlidcaial and an only to accessed by authorized county officials-The Depanntent 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
Malone, Sean D/Heather N
RI Box 478
Fort Branch IN 47648
7175
Sean D Malone
9923 S 250 W State Parcel Number Lesal Description
FORT BRANCH IN 47648-8145
I I III I I I I I III III V 'I I ' I 26-18-34-200-002.142-024 004-02142-00 PT NE 34 3 11 1.68 AC
I u ut I nt u u t u tat t n t t nt t o t a r D-27
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
S-e0.� �,, V�� I once
_ tg Address(number and street,city,state,and ZIP code)----- - -- - SCI-Same asproperty oddress----'- -- —'—— -- - —
9 ca 3 s • t2 so vJ FT Br(14/60. u»y7
Spouse , First Middle Last
�1 ea-Meg_ ;co%e- on
Mailing Address(Number and street.city,stale,and ZIP code) i Same as properly address
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury•,that the above and foregoing information is tone 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
•
•
\
/
r;� CLAIM FOR HOMESTEAD PROPERTY 7AX
CREDIT/STANDARD DEDUCTION
/ t'��• Sia�e Form 5�73 (R6 / M3)
Prescribed Ey the DeOartment d Local Govemmenl Finanse
INSj�j2UCT10NS: See �evcrsc sidc loyJiling mslruclinns.
C��
FORM
HC10
YEAR
� l`�'�el / T r ►����y ia&odit�d,sllda�/o�ar�,. zo_
I(We pied as our principal place o( esidence the following described real property (or which a Homestead Property Tac Credit is hereby daimed:
I(VJe) owned ❑ Are buying under wntracl APR 1 1 2005
, Have a benefidal inrerest in lhe eniity that is liable for the pmperty taxes on the properry and that owns the property or is buying under a contrect.
I( buyu�g om m�traa, Fee Simple ownefs name
Remrdefs oifice where cantrad is recorded
Recora number � Page
-...,.. ..» i,_ _
..:_"-.. '-.. ::- •`"�:PROPERTYOES IPTI N... _ .:,... °�'r"•- :;.1;-:. �_.
_�`% � r. +__ _
County Tawnship Tai tlislri t'f mwns ')
r I � Le9al descnption the property in question:
Q Real property ❑ Mobile Homo (/.C. 67.7-7)
If any porlion of the resiEentlal slrucWre or Ihe Wnd not exceetling ooe (1) acre that immediatety sunounds Ihai sWCture is used to O��uce income, desttihe the use antl portion
o( Ne property utilized to produce ifxome.
�a'� - ��-,3 S� �QO-ooa. isLa - a��
Counly
I hereby certify the above statements are We, correct and wmplete.
�ddress (number and slreel, ciry, sfate, ZIP cotle)
��� »..�� ._. r
��S',.%i:A�r.{i��:,ASSESSORUSE,ONLY�.- , � 'TVALUE
Land not exceeding 1(one) acre immediately
surroundingresiAentialimprovements. (�)
Other land �z)
TUaI land (line 7 plus line 2) �3)
Dwelling
Residential improvements or Mnually
Pssessed Mobile I Manufactured Home Garage
Other improvements
Tcial improvements (line 4 fhrough line 6)
Tctal value (line 3 phs line �
I hereby cerli(y the above is W e, cortect, and
wmplete.
Verilying action - Signature oflwtlitor
20 _ Pay 20 _
Lesser ot 1/2 Homes;ead
vauauon or 535.000
SignaWre
(4)
(5)
(6)
I�)
(6)
Signa W re of Asseswr
County
ofda"unant
IASSESSED VALUEI:-HOMESTE
. AT 100°/a OF�.TN- �_ � VALUE
'�=STANDARD.DEDl1CTIONALIOWANCE -
1
S
�
. NON�RESIDENTIAL„
-=k VALUE:' �' '
__- ,-i::�* _ _ .' .. _..
Yc'r �r_ '•F . �
Date signed
Dale signed
Date