Homestead_Mann (4) STATE FORM!l •i0.r-d) TRE4LEE7/EOM(7.3-M
.smen'EO BY•TAIEBOxtO OF VtTtAta.,). PREYIaBW BY 111E DEP/A/MeiOF LOX'AE tMCR.YMGT FINANCE M a,
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main '
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.Ilomestead fraud causes higher tax bills for all:therefore.
FIFA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to receive the
benefit and to provide additional identifvm^_ information necessary to allow county government to better monitor homestead
filineet 11th information will he kept confidential and can only he accessed by authorized county officials-The Ikpanment 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
Mann, Kent A/Mary A
- _ k1 Box I:
-- - - - _ Haubstadt IN 47639
714
Kent A/Mary A Mann
2696 W 1300 S State Parcel Number Legal Description
Haubstadt IN 47639-8702
1 26-22-15-400-001.060_024 004-01060-00PTE SE 15411 2.90 AC
—I-t ot{{n t{I{{tut II t I t I tut s I t I r III II t I l II {t I { — _ _
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
t\r_idr _ MAP,'
• —iT --
ig Address(number raid street,city,sine,noel ZIP cod-e) --- - `- -- - - 'G Setts as property ulwd --- '-- -- -- - -
26g6 W 13O IL ¢ Ntlf 65 `/
Spouse First Middle Last
414-Ay M1 r' X
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
LGE/ G ' /500 5 /IRN<Ii'tP7 FN y7679
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
a.� �'R°„ CLAIM FOR HOMESTEAD PROPERTY TAX FoRM YEAR
; �': CREDIT/STANDARD DEDUCTION ' HCio
�/� State Fortn 5473 (R2 / 5�92) "
�au
INSTRUCTIONS: See reverse side lor7iling instructions �- � �
�� � '� � - - CERTIFICATION STATEMENT ' �
�) ___�—� � ��� �� cert � h t o ihe�si d�. o, f Ma�rch, 19_
cupied as our principal place of residence the followin described real property for which a Homesiead Prope sjriereby Gaimed:
N . � .. . �����
(We) owned ❑ Are buying under contract �
❑ Have a beneficial interest in the entiry that is liable for the property taxes on the property and that owns ihe property or is buying under a wntract.
-- � � � ,. CONTRACT RECORDED, . . � � . .
It buying on contract, Fee Simple owner's name . � .' � . � _ .
Recorder's oHice where contract is recorded RecoN number Paqe
PROPERTY DESCRIPTION
Township
fown,
.. - v (//(XL�JL�
Parcel number Legal tles tion
0o v-oio�o.-co �� �`S'� l5-�t-� ). a 96
If any portion of ihe residential stmcwre or the land not exceeding one (i) acre that immediatey surmunds that struc[ure is usetl to protluce irimme, tlescn6e Ne use and portion
of ihe property utilized to produce income.
a�-�a-�s-�=c�/�o-oas` ' .
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Couniy TownsNp Counry Township�
•by certify the above siatemenis are true. correci and complete. Sig t e o� d iman�
�.,��I_ ��-
are (numberandstreetdry.s(ate.ZlPwde)
R/1I Oo,r i1� �ST�DT �� 4�6�9
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvemenis. (�)
Otherland (2)
Total tand (line 7 plus line 2� (3)
Dwelling (4) I � '
Residential improvements
Garage (5) �
Other improvemenis (6) .
Total impmvements (line 4 through line � (7) �
Total value (line 3 p�s line 7) (g) �
I hereby certify the above i5 �rue. Correci, and Synature ot Assessor Date signed
complete.
ing action � Signature of Audiror Date signetl
�
STANDARD DEDUCTION ALLOWANCE
19_Pay79_
Lesser ot 7/2 Homestead
Valuation or 52.000 5
otAutlii ,/ � /I/�� IDatesign—�
� C./ � �
�'