Homestead_Waters STATE FORM!!!M1ft:/Vnl MEASURER FORM TS-IA
APPROVED BY MAIL BOARD OF.AM NR.!vn PPIY[AIamavntr DEPARTMENT OF LOtALODv2R.VMFTr FM:ANCE IC 4-11-224.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to ore homestead,Tandani deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.Ilomestead fraud causes higher tax bills for all;therefore.
® HEA 1343-7009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he Lepr confidential and can only he accessed by authorized county officials-The Depannmr 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 f-/
Waters, Scott M �W
D (,
1{AUI1S"fADT'IN 37639'
10731
Scott M Waters
10667 S 525E State Parcel Number Leval Description
HAUBSTADT IN 47639-7842
�t�nl�ur�ll�nullr�u�nln�n�n�n�t�t ..�n Fl�Fr Fl� 26-23-01-200-002.162-024 TWIN OAK 7 D-10
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
5 co-it m aikhet.0 U3atecs
4111,g Address(number and street,city,state,and ZIP code) ® Same as property oddress-
1Otpto1 5wth 525 East I I-1o.,6 stadt, 7J<1 , 41(239
Spouse First Middle Last
VLrQ 1 ' C}
Q Rose erS
Mailing Address(Number and street-city,state,and ZIP code) Same as propeny address
101ob-I South 525 East I 1�Qu1J5{adtl 31\1 y-Ilo39
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 ll
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Stete Fortn 5473 (R6 / 403)
Prasaibed by Ne Departme`rt of Loral Govemment Finance
INSTRUCTIONS: See ieverse side /orTlirg instnictions.
�
FORM YEAR
HC10
i(we> V'� �-v t!�y� �.J Q�,c.�- �en�r�PA�i� o �m� i�006 of March. 20_
I(We) occupied as our principal place of residence Ihe following described real property for which a Homesiead Property T��c !Credit is hereby daimed:
❑ I(We) owned ❑ Are buying under contract �6� N�
' Have a benefidal interest in the enGty tha� is liable for ihe property taxes on the property and that own�S�p�tlN�iiu�f�i�hHer a wnVaU.
If huying om m�tract. Fee Simple owners name
office where conVad is recorded
Counry
Tavnship
description
If any poNan ol ihe resiAential sWCture or Ne Wnd not exceeding one (1) aae ihz
of Ihe property uGlized lo produce income.
/7i ( O �C1JyL" v i — �LC/ �
e_nast. __ _ ._ _... __ _ . _ .
��.?rx��'�?a,.'�'�'�;�"�� .�Li���`����PROP.ERTY,OWNED'�.B'
County Twvnship
I hereby certi(y ihe above statements are We, correct and complete.
�+A:
IRecord numEer I Page
ESCRIPTIONrr,„"k?�a.'N `��..�,a,''�$,��'.'�n?� ''y,'},.�'�'�.�;T,.��."�aq+�.+:3?
Tacing district (dry, fown. township)
Is the property in question:
❑ Real proparty ❑ Mobile Homo (I.C. 61.1-7)
iately sunounds that swcture is used lo protluce income, describa the use and poNon
Couniy
'+"�� ��ttI+„�'�� ''�``'r£'� Y`�"`--�^��an���'��`�'TRUETA7(� � ASSESSEDVACUE ��HOMESTEAD'``+, ' ' ��
�-c ,.`�,�c�� `��'-�ASSESSOR US�ONL �_ �y. �f� �' � y�VE�aF N . � pT,100% OF�TN� ��„�VALUE��� ��` � VALUE � IAL���E�
� �ix� +..V � _ 'yc
Land not exceeding 1(one) acre immedialety �3 ��" �'*'r%�� �`�-n
surrounding residenGal improvements (� � ����'� ,.-F�s+.� ��.--,
Other land z �+� ��F �
( ) tc �r�v,�'�
�.s. ��
Total land (line 1 plus line 2) �3�
T 4Q:L �>�x
i '� Y`-�'
Dwelling (4) �� ��, ��:�. ' ��.�
Rasidential improvements or Mnuaiy ry�f�.
Aasessed Mohlle I ManuFxtured Home Garage (5� T�zb."c�ti�� �� t��
sC,�,k's'^w' ��',ar'w. r .. 1�'_-=
ws��, �;
Other improvements (6) � in "''`� x
���:,�-�'
Tdal improvemenLs (line 4 through line 6) (��
Rial value (line 3 phs line n (g�
I hereby certify Ihe above is We, correU, and Signature of nssessor Date signed
complete.
Verilying actbn - Signature of Putlitor Date signetl