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Homestead_Hathaway O STATE FORM 5355q(P3/410) TREASURER FORMRtA = APPROVED B\STATE ROAM OF ACCOUNTS.219 PRESCRIBED BT TIE.DEPARTMENT OF LOCAL co'E 'sea FINANCE IC 6-1.1-124.1 Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 101 N.Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes C - Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore. HEA 1344-2009 requirestaxpalers who receive the homestead standard deduction to verify that they are eligible to receive the FILED flags. and ti ormiti addili be �pt cinid information necessary c s ed county ized cunt o to bear The Dr homestead o 46 . filings.This information will be kept confidential and can only be accessed by authorized 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 MAY 1 0 2011 Taxpayer Name Location Address C.3 - Hathaway, Paul Edward/ 3792E50N GIBSON COUNTY .. - PRINCETON IN 47670 552 Paul E Hathaway II-IIIII�DIII II II IIDIIIIDI .IIII�II IIlfiiiII_II_IIIIIII III III LIII011_IImIIIII 3792E 50 N PRINCETON IN 47670-8908 ' 1111111111111111111"1111111111111111111"111111111111"11111141 State Parcel Number Legal Description " 26-12-02-300-000.155-004 PT SW 2-2-10 5 AC D-7 C-i — � -- — . ' ; .. 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 Ce I First Middle Last P� ��. wA-1,D WfTi/ wA-�� Mailing Address(number and street,city,state,and ZIP code) . ICSL Same as property address 37 g / co/v. PR j%oci o A/2 /N. 4/ X 76 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 maybe liable for back taxes and substantial financial penalties. - . l Signatures r / - Date . a,.a rt,R4 ate' g CLAIM FOR HOMESTEAD PROPERTY TAX s 6� CREDIT /STANDARD DEDUCTION State Form 5473 (112 / 5-92) u. INSTRUCTIONS: See reverse side for filing instructions. ...... - - certify that on the 1st day of March, 19 real property for which a Homestead Rroperty Tax GedifT7 "hereby claimed: 4 a �t owns the property or 1sbL'ynl�ud� n act. _ CONTRACT RECORDED It buying on contract, Fee Simple owner's name Recorder's office where contract is recorded Record number Page PROPERTY DESCRIPTION Counry n^' C1 i( Township Taxing district (c' town, to nship) a Parcel number Ood -Do Legal description (5 %v a -C)-ID S fiC If any portion of the residential structure or the tend not exceeding one (1) acre that immediately surrounds that structure is used to produce income, descnbe the se and portion of the property utilized to produce income. Q� �� la-oa -cam r55 .m d-- d/O - PROPERTY OWNED B LAIMANT IN OTHER COUNTIES ` ASSESSED VALUE County Township Land not exceeding 1 (one) acre immediately surrounding residential improvements. County Township ®eby certify the above statements are true, correct and complete. ' S ure of claimant ^ !mod Address (nu m r tr ,dry, state. e) ASSESSOR USE ONLY TRUE TAX .VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL. VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements. (1) lure of krok tlito ' Other land (2) Total land (line I plus line 2) (3) Residential improvements Dwelling (4) Garage (5) Other improvements (6) ' Total improvements (line 4 through line 6) (7) Total value (line 3 pins line 7) (6) , I hereby certify the above is true. correct, and complete. Signature of Assessor Date signed Verifying action - Signature of Auditor Date signed I - - STANDARD DEDUCTION ALLOWANCE. - - 19_Pay19_ Lesser of 1/2 Homestead Valuation or $2,000 S lure of krok tlito Date signetl 7 Ls - - /a-g f