Homestead_McKee STATE FORM 53569(R2B.09) TREASURER FOR::TS-IAI
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-LI-22-8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
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
Sauses higher tax bills for all; therefore, HEA 1344-2099 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 Local
Government Finance will use this information to create tools that will help county officials eliminate
homestead fraud.
PAR I: PROPER Y I`FORMA ION
Taxpayer Name Property Address State Parcel Number Legal Description:
Stacey/Lynette R McKee 2512 E Classic Dr
26-23-16-200-001.944-024 004-01944-00 RIDGE MANOR EST
HAUBSTADT IN 47639 FILE ])
J)
Complete and return to:
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 APR 2 0 2010
PART 2:TAXPAYER INFORMATION - .1r2/ �: sG°_
Owner I First Agddle ey i Last •
•
SI-4ct R 4 �I saP ooUTY AUDITOR ,
Mailing Address(number and street.city.stale and ZIP code)l /Y I 1C
Same as properly address
5 1 a E C InSS;c Dr ; VC. ) 41l S 4df, 1- I.7 47G 3 9
Sparse First Middle Last
L. 1 h tiic_ R-e vile /4 c..-/ e C
Mailing Addisa(number and street.city.state and ZIP code) Sane as property address
a 5 1 a E classic- pry ✓ e-1 1 r' au R-1-actf, -± N Le l G 3 q
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 • Lured Date
PART 4: ADDITIONAL INFORMATION. .
CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
t � State Form 5473 (RS I 10-07)
uu Prestribed �ha De
by partrneM of Local Govemmenl Finance
INSTRUCTIONS: See 2verse side lor filing instrucfions.
FORM
HC10
�iil
YEAR
� M�8) L-L /� certfy fdat pn �e� st qi March, 20
�'IHR
I(We) occupied as our principal pla of residen fol wing described real property for which a Homestead Property � ls hereby daimed:
❑ I(We) owned ❑!ve buying under contract �%/� /7�( � ///�
�Have a benefidal interest in the entiry that is liable for the property taxes on the pmperty and that oxms�tlie�propgE ,w isbby"u�g�u�e[a contraG.
� �
3IRCn1JCi'1fikTY alirdTll�
I( buying on contracL Fee Simple ownets name
Recarders aifica where conVacl is recordeO
Tavnship
� �� �=0(9 Uu-c� I�i1�
N eny porUon of Me rasiAenllal etructure w Ue land not
W Ue DroOeM u1S¢ed tn produce income.
7aing disVid (dry, t
i me v�oi
(t ) aue Net im w ds ihat
�G-o?3 - /G -�o� - 00% 9Y� o��
Record number . � Page
al Draperty ❑ Mobila Homa (I.C. 6/. f-� .
Is used to protlute (ntome. dearnbe the uae and portbn
20_Pay20_
Lesser of 12 Hanestead
Valy3�ion or $6,000
1
$
Date