Homestead_Tenbarge (11) at VE IMAM`)w Mr/s-ro TREASURER FO0.43IA
sRrR„vE IMPORTANT NOTICE TO DEPARTMENT. CW LOCAL
PROPERTY COVER-WENT
O��NERS I '4
Gibson County Auditor
101 N Main
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 incentive than e'er for homestead fraud.Homestead fraud causes higher in bills for all:therefore.
® HEA 1344--2069 requires taxpayers who remise the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide adttitional identifyine information necessary to allow county government to better monitor homestead
filings.This information will he Lepu confidential and can only to accessed by authorised county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Tenbarge, Randall J/Janet L
RI Box 85
Ilaubstadt IN 47639
9440
Randall J/Janet L Tenbarge
10588 S 310 W State Parcel Number Legal Description
Haubstadt IN 47639-8633
1
III 1111 I I I I I I 11 I I I I III I I I III 26-22-03-100-000.373-024 004-00373-00 PT E W 3 4 111.261 AC
11 111 t 1 1 11 11 1111 1'' 111 t Ir rl I r _ -- _ - __ _ _- _� ..
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
120,■A-& t Hof �� r9
g Address(number and street,city,state,and ZIP code) - _ - ( f Sarre us property address- — - ---
JOS0B S 310 6-4.A._53- -' f £7c,39
.>
Spouse First Middle Last
e -\\e, \L
Mailing Address(Number and street,city,state,and ZIP code) E Same as propeny addra
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
i� CREDIT/STANDARD DEDUCTION
.�� • S[ate Form 5473 (R2 / 5-92)
ou
1NSTRUCTIONS: See reverse side !or filing instructions.
FORM YEAR
HC10
�
��tWe) � i that on t tgi ay of rch 9
�le) occupied as our principal place of re ence ihe following described real propert o which a Home Pr � aimed:
u i(We) owned ❑ Are buying er contrect � �:3SO:d CC��`" n:!��Tv^.°.
❑ Have a beneficial interest in the entity that is liable for the property taues on the property and that owns the property or is buying under a contraci.
--.: � _ , .... . . .,. CONTRACTRECORDED:."`. .. . �.- : - .'.,. ' . -,. � c:�i � ' - �-� :yJ,s � .
It Grying on contraa, Fee Simple owner's name
Recortler's oNice w�ere contract is recortle0 Recortl numDer Page
Counry
Township
. �PROPERTY
iOWll, iOWIlSillP)
k.
Pa�um r ��� Legaldescriptiop / // //7. / 0 /� . / // /
\.//-1— / � �5 _ .L,[ �
/— / J L.LJ O/ /
Ii any ponion of the residential simc[ure or the land no� exceetling one (1) acre Ihat immediately surrounds that swcture is used m praduce income, describe the use antl portion
of the pmperty utilized to produce intome.
_ a� _�3_4 _ /OD-QoO.
� PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES � -
Counry TownsNp Counry Township
�reby certify the above statements are true, correct and complete. Signamre of claimam
Address (number and streer, ary, state, ZIP cade)
ASSESSOR USE ONLY TRUETAX ASSESSED NOMESTEAD NON-RESIDENTIAL::':
. . � � VALUE VALUE VALUE VALUE - - �
Land not exceeding 7(one) acre immediateiy - �
surroundingresidentialimprovements. (�) � °�� �
Other land (z) �
Total land (line 7 plus line 2� �3)
Dwelling (4) � . �
Resideniial improvements _
Garage (5)
Other improvemenis (6) -
Total improvement5 (line 4 through line � (7)
Total value (line 3 pLs line � (g)
I hereby Certily the abOVe i5 Irue. correci, and Sgnacure of Assessor Date signed
complete.
�tying action - Signature of Auditor Date signetl
79_Pay19_
Lesser ot 1/2 Homestead
Valuation or 32,000
$
signed