Homestead_Williams •
SLUE FORM.539.1113 P-101 IRAWRLA IORV IS-IA
ARRO\tn By'TOE:V1\Rn Of lu'NIS..nn IRINRdEDHI'Tr4.O1PARLVtT OF t Ot1Atcovexwisr IMANCCR'br:$-u
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY-OWNERS^
101 N. Main Street Individuals and married couplet are limited to one homestead standard deduction.As the receipt of this deduction becomes
Princ I n I 47 0 more beneficial.there is more iceenti.c than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore,
1 IIE.\ 1344-2IX9 requires taxpayers who receive the homestead standar]deduction to verify that they ant eligible to receive the
benefit and to provide additional identifying information necessary in allow county govcmnam to bent" monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Depanmert of
Local Government Finance will use this information to create took that will help county officials eliminate homestead fraud.
MAY 14 2012 PART l:PROPERTY INFORMATION --
C N Taxpayer Name Location Address
Williams, Greg L
GIBSON COUNTY AUDITOR 125705 OWENSVILLE RD
HAUBSTADT IN 47639
9667
Greg L Williams I IIi[[[II-[111011 [[[1[[[[ [_MOD 110[11.111111I 11111[[0II1 II [IllIll[I nil
12570 S Owensville Rd
HAUBSTADT IN 47639-8703
11111111111111"1111111111111111111'11111191111111111111'111111 State Parcel Number Legal Description
26-22-15-300-001.107-024 PT SW 15 4 11 6.10 AC 0-2
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.
• • .4 e..
-r I First Middle Last —
6 e6 L 1,11/2I69/QC
Mailing Address(number and street,city,stare,and ZIP code) Same as property address
)x.570 S dG(yesa/LGt AD NA0.9STIPT 97(37 ,
_ . - - -
Mailing Address(Number and street.city,state,and ZIP code) 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)
I I I I Sea
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 properly.Each undersigned also understands that,by claiming additional homestead deductions 0
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I S. nature Date
• .
i
CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
Siale Fortn 5473 (R8/7-07)
^�,• � Prescnbed by Ihe Deparlmerrt of Local Govemment Finarae
WSTRUCTIONS: See ieosrse side )or fi/irq instruc6ons.
C�
FORM YEAR
�
e) ��/ certiry that o`the's,� arch. 20_
e) ocwpied a r prindpal place of residence the fdbwing described real property for which a Homestead Pmy erty T�c �edit is by daimed:
I(We) owned ❑ Are buying under conhad GIBSON COUNTY AUDITOR
Have a benefidal interest in the en6ry �hat is IiaWe for the property taxes on the property and that owns the property or is buying under a contrad.
Ii buying on oonUeq, Fee Simple awnefs imme
Recorders of4ce whera contrad is recordad
County
Parcd number
Tamship
Tanng disUict (cGy,
Ute
��TL% W � ✓ � �� h . �U
H eiry portion of ihe residerrtial sWaure a the WM not e�cceedirg one (7 ) acre ihat immediately surrounds that
ot Ihe property uli5zed b pmduce inmme.
��-aa-i�-3oo-�/ �v�-aa�
Record number ( Page
al property ❑ Mobile Home (IC 6f.7-�
is usad in produce inwrtre, describa Ure use aM ponion
.- .
. . .. . .
„..
Land not exceedirg 1(orre) ave irtvnediatety -="` -.'"`."`':.`: "`•` �'-: .
surroundirgresidentialimprovemenfs. (�� �� � " '
OfherlarW (2) . =.�
c. > ,'. ...
Tatal Iarn1 (line 1 plus I'me 2) �g�
Dwelli ='*-w„��n� �cY c:i"^"ti i�r,1-��7 �;
ResidentialimprwementsorMnually � �4� �` � �':k��.,r' '`t.'�2`-0- ;s. r.:,:�
AssessadAAobile/Manufach�redHome ��9e 5 �'.Y��`�^�,u,.*�,�.".�'-�`�=' � ��--
( ) .=�:...�YtS at:^� ;c�-t•..;-n'=, -
Other improvements (6) _:}�`�"-"��''��'
_ iy.'
Tatal improvements (line 4 through Grre 6) �7�
Tdai value (line 3 plus Grre � �g�
� nereby certiry the above is true. c«rea, and sqraw�e oressess« oate signed (mont7i. aay, rea�
complete. �
Veifying adion - Sipnature of Autlibr Dale signed (mmth. daY• Y��
�•'�� � • •
20 pay 20 _ qs,ppp for 2007 pay 2008 42,000 for 207 0 pay 2011
Lesser oF 12 qq�000 for 2008 pay 2009 41.000 for 2011 pay 2012
Homestead VAuation S
a 43,000 for 2009 pay 2010 40,000 payable after 2072
SignaWra of Audta Dale signed (month, day, yea�