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Homestead_Meny (6) • AMC.ED BY CterE BOARD OF ACCOUNTS._nn fAhYWPfSI PY THE nEIMTff.Yr(f LMTL fnn2LYMEFT FINANCE 1C11-1.1-22-It I Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and married couple> are limited to one homestead standard deduction.As the receipt of this dedttnion becomes _ more beneficial,there is more incentive than ester for homestead fraud.Homestead fraud causes higher tat bills for all:therefore. HEA 1344-2IX9 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to receive the benefit and to provide additional identifying information necessary to allow county gosemmenl to better monitor homestead filings.Ibis information will he 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. PART 1: PROPERTY INFORMATION - Taxpayer Name Prole • - i . _ Meny, Randall R/Mary S 406 N Polk Fort Ilmnch IN 47648 9546 Randall R Meny 665 W 1220 S State Parcel Number Leea1 Description HAUBSTADT IN 47639 26-22-13-200-000.010-024 004-00010-00 PT NE 13 4 11 1.00 AC X PART 2:TAXPAYER 1NFORMATION 1 First Middle Last ;MO/9 Address(number and street,city,state,and ZIP code)- LJSeme as property oneness _ (P(C 5 U) 1;005 Hftu8s?l4DT .Li . LI 7Cal Spouse First Middle Last Pq A R ty 5 pep eto Li Mailing Address(Number and street,city,state,and ZIP code) [ Same as property address (o6).5- W /2_O © S (419 085 CDT j £ 47CO3 of 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. Ow nature Date ,- 7 ._ �, CLAIM FOR HOMESTEAD PROPERTY TAX ' CREDIT/STANDARD DEDUCTION � Slate Fortn 5473 (R614-03) Prescri6ed Oy the DepaNnent of Local Govemment Finance INSTRUCTIONS: See �evcisc sidc 7or /ilinq insl�uc(ions. FORM HC10 YEAR ��e) " � � e cerU(y ihat on ihe��lsl day of March, 20 I(We) occupied as our principal place of residence the (ollowing �bed real property fo ich a Ho�stead Pro�p�erty, T�if��eieby daimed: 1� �--� ❑ I(We) owned ❑ Are buying under conUact � Have a benefidal interest in the enGty tha� is liable for the property taxes on the property and that owns ih�'�erty or i�g under a conVaU. If buy'ug om m�uaq. Fee Simple ownefs name canVaa is recwded County Toxnship GIBSON �' �t � r? ; � Tating dislrict (city, town, townshiP) Record num6er Page � i�VK/IU �� I�,Je��� '�� •�l � l, 1 Is ihe GropeO^Real W DeRY ❑ MoM7e Homo O.C. 67J-7) If any poAion o/ Ne residenlial structure w the WnA not exceeding one (1 � aae that Immediatey surrounds that sW Gure is used fn produce income, describe the use and portlon of the property utitized to produce incoma. c��- aa-�.3-�ao-�6oe D/o- 0�5� �o��,Y I hereby ceAi(y the above statements are We, correct and complete. Address (n ber and s7eet, cit}; st ZIP code) � , i2 2 r i�"ox 3� i � u Land not exceeding 1(one) acre immediatety surrounding residential improvements. Other land . Tdal land (line 7 plus line 2) Dwelling Reside�al improvements or MnuaOy Asse�ed MaOi�e / Ma^ulac�red Nome Garage Olher improvements Tdal improvements (line 4 through line 6) Tatal vatue (line 3 phs line � I hereby certify ihe above is W e, mrred, and mmplete. Ve`iying action - Signature oflwditor (�) (Z) (3) i4) ' (5) (6) (�) (B) SignaWre ofAtsessor co���Y Twvnship Date signed Date signea