Homestead_Osborne •
RATEFot I:Wen It:t5-Wl WREANIIAPoRM11A
fr.rtRIw'EnaY MATE Nt Dot-M-tT*L Tt'Ir .PRTYN■ED BY THE DEPARMEYC(ELD,AL r4NER.YMFAT FINANCE Pe 6-I.1-'J.1
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&conics
more beneficial,there is more incentive than e■er for homsteal fraud.homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpasers who receive the homestead standard deduction to verify that they are eligible to=else the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.this information will he kept confidential and can only Iv accessed by authorized county officials.The Ihpanment of
Local Government Finance'rill use this information to create toots that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
—. Osborne, Kim M
Rr 2 Box 58a
'au.sta tIN 47639
10760
Kim M Osborne
4132 E SR 68 State Parcel Number Legal Description
HAUBSTADT IN 47639
26-23-02-400-001.685-024 /004-01685-00 PT w E 2 410 4.00 AC
t/ 0-10
sl:V
PART 2:TAXPAYER INFORMATION 3 •
Owner I First Middle Last
6e2A/T
iii
Ig Address(number and stmt,city,sure,and ZIP code) — -- - — — Same as property address -
'S 73a r 67[CE /e06, 7 - 1/ /(74787
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) El Same as property address .
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
5=
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 $igna/tr'e a Date
•
CIAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2 / S92) -
INSTRUCTIONS: See reverse side lor �ling inshuctions. .
CERTIF�CATION ST
FORM
HC10
•� i
YEAR
I e 1 � certi (.th�qat n.the�t� ,yg f March, 19_
I(N/e) occupied as our principal pl e of residence the follo ng described real pro f ' h�a Homestead Prbpe� Tax+Cret7R�ereby daimed:
�� �C.� -1 c1�'-� ^ � /� �
✓ I(We) owned ❑ Are buying under contraci ; /'
❑ Have a beneficial interest in the eniity that is liable for the property taues on the property and that owns the pyope�tjr-or:is buying�urtd'er.a'contract.
��GI6S0°? _' ' '?v p!J('i!1Ca �
on conVad. Fee Simple owners name
Recorders oHice where contract is recortletl
CONTRACTRECORDED
PROPERTY DESCRIPTION
Taxing dis}pt� �dry,
Parcel number L al tlescription �\
�oH-oit��SS-«� �� L.� � a:-4-�� �
It any portion of Ihe residential strucmre or ihe land not ezceeding one (7 ) acre Nat immetliatety surtountls ih�
Ihe property utilized to protluce income.
�� -� 3 - D� - i`ao - G�1! � �� Do? `�
fown5hip)
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
p Counry
I hereby certi(y the above statements are true, correct and�complete.
Address (number and street, city, sfafe, ZIP cotlef
ASSESSOR USE ONLY TRUE TAX
VALUE
Land not ezceeding 1(one) acre immediately "(� �
surrounding residential improvements.
Other land (2)
Total land (line 7 plus line 2)
Residential improvements
Other improvements
(3)
Dwelling (4)
Garage
Total improvemenis (line 4 th�ough line 6)
Totai value (line 3 plus line 7)
I hereby certify the above is true, covect, and
complete.
'ntying acfion - Signature of Auditor
19_ Pay 19 _
Lesser of 1/2 Homestead
Valuation or $2,000
(5)
(6)
(�)
(8)
Signature of daimant
ASSESSED I HOMESTEAD
VALUE VALUE
STANDARD DEDUCTION ALLOWANCE
$
�
NON-RESIDENTIAL
VALUE
siqnetl
signed