Homestead_Pickens •
STATE FOAM sby.oty/>.1n0 TFASUIFA FORM TI-IA
.Arrrn'ED B Y BOARD O F RIMS.Zion PALwtltIUInY TIM OFPARThe4T OF LOiLLCAWEINNFNT FI:ANCEIe61.1-r'-I.I
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 Lnunles
_ - more beneficial.there is more incentive than ever for homestead fraud.Ilomestead fraud causes higher tax bills for all:therefore.
HEA 1341-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing..This infosnation will he kept confidential and can only he arcec■ed by authorized county otfcials.The Depanntent of
Local Government Finance will use this information to create toils that will help county official,eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Pickins, Earl Wayne
gt-if B.dS R3 33 261'
llaubsadt IN 47639
3437
�Vt 5
Earl Wayne Pickins
150E Hirsch Wood Lane
HAUBSTADT IN 47639-8832 State Parcel Number Legal Description
' I II III II I I ' I I I II I I I I II III 26-23-07-200-001.651/4--024 004-01654-00 HIRSCH LAKE ESTATES 6
— — F u uF t nn t t n n t n nt nt t t t t nn t t — ..__ _—`__D_9
_ ____ — - -
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 •/ Middle Last
ig Address((number and street,city,state,and ZIP code) �J [ `f ) l� :me as property address
1 0 G ///FSG4 1/0015 1,0 / Lj5/f / /� 9763 7
Spouse First , Middle Last
l"J
Mailing A and street,city,state.and ZIP code) 12a.- --e-as property addrtas
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
- CREDIT/STANDARD DEDUCTION
� � Stata Fortn 5673 (R8 ! 7-07)
��w PrescnLed by Ihe DepaMiBM of Lotal Govemrtrent fifance
INS7RUCTIONS: See reuerse side /or filing ins6uctions.
FORM
HC10
YEAR
IM�e) � 4�/S�. V�YQI.I IL-� �v.���XIY�J certifythaton�LstEap�ot�Mmch.20_
I(We) ocwpied as our principal place of �sidence the fdbwing descAbed real property for which a Homestead Property ac Credit is hereby daimed:
I(We) owned ❑ Are buying under mntraU �7�� ,/��
% -�
Have a benefidai interest in the entiry that is IiaWe fw ihe property fazes on the property and Uiat owns ihe proG rty ONsCbuymplutd��G.
___ BS UUNIY
If buycig on wnfraq, Fee Simqe ownala name
of4ca where conUaa is recorded
Township
Legal
Ta�ing district (ci(y,
Is the
It arry porUOn of Ihe residerNal sUUCture or Ne land not exceetlirg one (7 ) acre that immediately wrtounds that
of Iha properly uliGZed b pioduce incOma.
Record number � Page
property ❑ Mobile Fbme (IC 6-1.
is used lo pmduce inwme, describe Ure use and porUon
�' •
� • . � • �
�i'. •
Land not exceeding 1(o�re) acre immediately •` � `-�.;, — .
�
surrounding residential improvements. ��� F s�,1
Other lard �..�.�' �. .4,..,,
�Z� � �'-`.: �: -`
Tdal Wrnl (line 1 plus line 2) �g�
Dwellirg (4) - �� �, � �
Residential improvements a Mnually -
A55e55ed Mobile / ManuFaCtured HOme ��.... r?' �,.
Gara9e (5) - . ' .
y.
Other improvements (8) �Y �:`. � .
,=�:
TUaI improvements (line 4 thiough line 6) �7�
TUaI value (line 3 pLs Grre n (8)
I he2by certify the above is We, correU, end Signature ofPSSessor Date signed (monfh, tlay, yea�
complete.
vai�;�y eao� - senawre ota,ai� Da1e signed (month, day, yea�
2b _ pay 20 _
Lesser of 12
Homestead Valuation
a „
45,000 for 2007 pay 2008 42,000 for 2010 pay 2071
44.000 for 2008 pay 2009 47.000 for 2077 pay 2012 5
43,000 for 2009 pay 2070 40,000 payable after 2012
ina�nN`pay: yea� �
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