Homestead_Mattix .1ttE OE,M,)W 111_!fall TRTAfll&IR EOM(73-IA
MTN Ell Br TI Mt BOARD OE M-.. VON Nm PE6YWBWD BY no DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC 4-1.11.'-EI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS •
PRINCETON IN 47670 Individuals and married couple..are limited to ore homestead standanl deduction.As the receipt of this deduction becomes,
_ more beneficial.there is more incentive than net for homestead fraud.homestead fraud causes higher us bills for all:therefore.
HE.\ 1344-2009 requires taapacers who reccive the homestead standard deduction to verily re that they a eligible to receive the
benefit and to provide additional identifying information necessary to allow county goverment to better monitor homestead
filings.this information will be kept confidential and can only be accessed by authorized county officials.The Dv-pannteni of
Local Government Finance will use this information to create tools thai will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Mattix, Patrick UJeri A
2532\\' 1300 S DR
•
_ IIAU13STADT IN 47639
9610 ,I ,
Patrick L Mattix
2532 W 1300 S State Parcel Number Legal Description
HAUBSTADT IN 47639-8701
1r1tr11tt t1t11rtt t��t�t�tt�tt�t�ttt��� ��r r��r rr�r���rrr� 26-22-15-400-000.657-024 004-00657-00 PT E SE 15411 4.0013 AC
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
1&kcK i •s
•ig Address(number and street.city,state,and ZIP code) - - --U.Some as property address — - --- —- 1 -5g l}3 l3 I300 6 ( 4ccubs-I-ccol4 1 Li7cu35
Spouse First • Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
e2 533 t.`) 1300 S HctibsiocH , ,v (-4-7 co 3
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 ai>d understands that;by ciaiming•additional-homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner 1 . naure Date
•
� rt� t CLAIM FOR HOMESTEAD PROPERTY TAX
'�-'� � CREDIT/STANDARD DEDUCTION
6��� Sute Form 5473 (RS I 10-01)
Prescribed by the Depariment of Local Govemment Finance
INSTRUCTIONS: See reverse side 7or filing inswctions.
FORM
HC10
YEAR j
I
._J ,,, l: L-vL
I(We) __ certify that on the 1st day o( March. 20_
I(We) oc pied as our principal place of r� ence Ihe following de cribed real pr erty for which a Ho �stead Property Tai-Credit is,h'ereti ' daimed:
�n I(We) owned ❑ Are buying under contract G��BS�N C��tiTY AU�
Have a benefidal interest in the entity that is liable for the pmperty taxes on Ihe property and that owns the property or is buying under a conVact.
"'._'x'?�.?.��;✓^'i.�,.o+...r_�.�,�:_ v�'_..•�°.' ,.ci's`.�,�.'-.CONTRACT�RECORDED:c�,.. ;.s - . ,
If buying on contrad. Fee Simple owners name
Remrders office where contracl is recorded Remrd number Page
� :�.a
Tavnship
S1S/ � V`� lY5 %—��ega(,.@stnp{wn �. �+ /` cl� l l
//A� �
/ � �i � ] /—
If any portirn of the residential sWCture w the IanC not exceeding one p) aae Nat immeCiatety sur
of Ihe property utilized to produce inwme.
�I_"�r��i/iQ
�
I hereby certiy lhe above statements are true, wrrect and complete.
ciry, state, ZIP code)
�ox �as r-J�
�
:;,r
@
�eal property ❑ A7obile Homo (I.G 67. f4)
sWUUre is used lo Droduce income. describe Ihe use and portion
�� �'EGQw-��� ` '�'' '"' r �= "� � �'.�.,TRUE�TAX , '� ASSE$SED VAI:UE � HOMESTEAD� � �� " „'„ NON-RESIUENTIAL" y.-=
.,yE,�,�-.�y�,t�ASuESSOR�U,S�ONLY ;^ r. - VALUE�; � AT �00°/a OF.�.TN � � VAIUEn k�. {� �` # ' .: VALUEy;,F"" �ys:,y=
h ..].mf.
land not exceeding 1(one) acre immediately <-F ��, '"z 4;' � ".'
sunoundin residentialim rovemenis. (�� - r '. °i � +' `` _ ^ ��
9 P ';�....�°=-' :.3?--:':,"
ni5�.. , .
Otherland (Z� - �--�;S:;�ta�
Total land (line 1 plus line 2) (3�
Dwellin 4 < Y t ' �' � �v } � �t -�:
9 I ) -�`' � �°s` s.c
Residential improvements �� 4 � S� {''""�`k �''��' �'
Garage 5 .`.+��'� �..�,�'-3�s°��'� �i�
( ) . C�?-,-s-" .,( . r."
�., >":.,�.•
Other improvemen�s (6) �, . �.i ii'' �e;
.�'fi-:,r,�..:: �..
Total improvements (line 4 through line 6) (�)
TUaI value (line 3 phs line n (g)
I hereby certiTy �he above is We, cortecl, and Sgnamre ot,�ssessor oate signea
complete.
Verilyi(g aclion - SignaWre oflwAitor Date signed
20_Pay20_
Lesser of 1/2 Homestead
Valua4on or 56.000
fwditw
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