Homestead_Norman '• MATE FOrt1!!'M It/%d t IRLASnatZ DORM 9IA
APPROVED BY flat.BOARD OF MtU 1&Y•S Puasis DBY tnrc DEPA127%E4TO(LOCAL n)xCtMMrTf FINANCE IC 41.1r4.t
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 incentne than exer for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344--2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recent the
benefit and to provide additional identifying information nemory to allow county government to better monitor homestead
filings.This information will be kept confidential and can only M: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 Property Address
Norman, Jeffrey W
R2 Box 65
llaubstadt IN 47639
37
Jeffrey W Norman
534 E St Rd 68 State Parcel Number Legal Description
UBSTADT IN 476 •- 87
26-23-02-300-001.819-024 004-01819-00 PT W 2 4 10 3.00 AC
111111111 +_'r I n a I I n I I I tit I I tit I n I I n f n I1'1 I I I D 9
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— _ _ . _._.
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORMATION
Owner I First 1 . C Middle Last
-/^� ,ii eel rte, N0401,4.l.)
•erg Address(numger and street,city,state,and ZIP code) a Same as property address
3534 67 sT ma_ Gs /Seen— /4, 45,999
-
¢
Spouse First Middle -- , Last
Mailing.Address(Number and street,city,state,and ZIP ri+derl 9 Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
r
__ _ _ - _ _ Sex
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
•
° CLAIM FOR HOMESTEAD PROPERTY TAX FORM YeaR
CREDIT/STANDARD DEDUCTION Hc�o
` State Fam 5473 (R8/7-07)
w� Prescribed by Iha Deparlment o( Loral Govemment Finance
INSTRUCTIONS: See /everse side !or filing insWctions.
� iNe) certify that on �€ist ��of`M�r�h. 20_
I(We) ocw ' as �na ace of residence the fdbwing described real propeAy fw which a Homestead Propert}+S�c�C�t is �y daimed:
I(We) owned ❑ Are buying under contract �� ��
Have a benefiaal interest in tlie enfity that is IiaWe fw the property taxes on the property and that owns the pro�r o�srboy�'i�LX���d.
If birying om m�iract, Fee Simple wmefs name
RecorAefs d.6ce where conUaa is recordad
County Twmship
1•
IRecord number I Page
• • •
Tm�ing tlislticl (cify, town, fownship)
Is Iha proparty m queslion:
❑ Real property ❑ Mobile Home (/C 6-7.
If any portion of Ure rasidemial sWdure w iha Wnd not exceedirg orre (1) acre Ihat vnmedatery artounds Ihal sln�cture is used �o produca income, descnbe the use aM pohion
d Ihe property uliGzad to produce incmne.
•- • -
� • .� � �
��'. •
Land not ezc�ng 1 (one) ave immediately "" . - �� '� ' � ' ' - � '
surroundingresidentialimprovements. (�� � " � .. '
Other land (2) . . .
Tdal land (line 1 plus line 2) �g�
Dwellirg (q)
Residential improvements w Mnually
AssessedMObile/ManufactiredHome :"ra.-'���..:�-,''-�. -
Garage (5� ��:.�...',.. ,,, . . . .
Other improvements (6) � � -
Tdat improvements (line 4 through Grre 6) (��
TUaI value (line 3 pltsliire n (g�
I hereby certify fhe above is We, correct, arM sigriewre otAssessor Date signed (monm, day, year)
complete.
Vaifyirg action - SigroWre ofAUditor Date signed (monN, daY.Y��
e0 _ PaY ZQ _
Lesser of 12
Homestead Valuation
w
45.OW for 2007 pay 2008
44.000 for 2008 pay 2009
43,000 for 2009 pay 2070
SignaMe of �br 1
�� V
42,000 for 2010 pay 2011
41,000 for 2011 pay 2012 $
40,000 payable after 2072