Homestead_HeldtGibson Counry Auditor
101 N. Main Street
- Pnnceton, IN 47670 �
� FILEI�
STASEfORM
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� TRFAA'W3iORNTS��
Indiriduais and married mupics are �limimd m oue homatrad itandand deduaioa As ;h< receipt of�this deductiov hecomes
morc brneficial, Ihcrc is marc incrnti�x tlwi nxr foi Iwmrstead f2ud. Homestead faud muus higher uu biLLs for all; �hercfore,
HEA 1314-?009 mquims tazpayxrs airo recenr �hc homestcad standard dcducuon lo �crify ;hat [hcy a`re cligiblc [o reccrvx thc �
'bencfi� and to prm�idc additional idrntifi�ing inPormalion nccessery to allow county gaxmmcnl to b:nsr monitor�Mmrstend
5lings. Tlds information will be kept wnfidrncial md can only be accessed� W auchorized rnunry of5cials. The� Deparvnrn[ af
l,ocal Grn�emmmt Finance will use ihis infomution m crtate taols that will help counn� ofTicials eli:ni�ate Irommead fmud.
APR 2 5 2011 ' � ' -
— TaxpayerName LocationAddiess
_ C'�'�� . � �Heldt, Beverly A
— GIBSON COUNTY AUDITOR ` � i77a E i5o�5
PRINCETON IN�47670
3666
� � � � � � -� � II01�I11��III �IIDfl�lll I� II �il�ll�ll�il��ll�ll�lll �II�I�
Beverly A Heldt
1174E150S .
Princeton IN 47670-8716
�'ll'I"I�"I�Ilillll��'���'��'�II'�"�I�I'�I��"�'��'�'�'�II��II StateParcelNumber Leaa
, 26-12-17-400-001.919-02�PT W SE 77 2 70
9
This form MUST be returned to County Auditor's office.
Please do NOT send this formback with your tax payment to the cou
ailing Addras (numbcr and strec4 city. state. end ZIP codc)
��%y � ��� � �Rlni�
Address (�umbcr and mect, ciry, statc, and 7.IP codc)
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e m Numbcr �(last 5 digits) � Otha (please spccify in Part 4
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ID Numbcr (lazt 5 digitc)
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�� Slare
n��aai�
, � Samc at property address
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AC D-10
treasurer.
undersigned certifies, under penalty of perjury; that the above and foregoing information is we and correct and that he ur she is eligible to
+e the homestead standard deduction on this property. Each�undersigned also understands that, by claiming additional himestead deductions
�fully, he or she may be liable for back tarzes and substanaal financial penalties. � _
� 1 Signaturc � n f � .. Date - � Telephone = - .. ., � , . � .
n . t �
y-��-� � � -
�yu, Telephone�
� �
� .�.E•••=• CLAIM FOR HOMESTEAD PROPERTY TAX
d, �'�A 4 .. �
; �i'� -y : CREDIT/STANDARD DEDUCTION
�'� +�, ' .' State Form 5473 (R2/1-90)
_, °�^ I� INSTRUCTIONS: See reverse side for liling instructions.
; .�-� .
I � . CERTIFICATION STATEMENT
FORM _ YEAR
HC10 `
'� � ✓
���n/e� �' C. certify that on the 1 st day of March , 19 �
I(We) oc u� d�s ri ci a place of re idence the fqllowing described real property for which a Homestead
�/
Property Tax Credit is hereby claimed: qd I(We) owned ❑ Are buying under contract
� Have a beneficial interest in the entity that:is liable for the property taxes on the property and that owns the
property or is buying it under a contract.
If
County
CONTRACT RECORDED
on contracL Fee Simple Owner's Name
office where contract is
Record Numbe�
PROPERTY DESCRIPTION
Taxing District (City, town,
Page
Parcel Number Legal Description g p�
'�� -�iqlg-C� ��l,J��d .�.e..��U �7—�-/D -I• :�
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
� .. -
,� -" � County
I hereby cenify ihe above
PROPEFiTY OWNED BY CLAIMANT IN OTHER COUNTIES
Township - County -
are true. correcfand
Address (Streei, number. city, state and ZIP code) Q �
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
NON-RESIDENTIAL
VALUE
�and not exceeding 7(one) acre immediately
surrounding resideniial improvements (� )
Oiherland (2)
Total land - line (7) plus line (2) (3)
Residentiaf improvements - Dwelling (4) - � - � � � -
Garage (5)
Other improvements (6)
Total improvemenis - line (4) ihrough line (6) (7)
Total value - line (3) plus line (7) (8) �
- I hereby cPrtify the above is true, Signature of Assesor Date Signed
('r-�i '� �and complete
�. J rifying Aclion - Signature of Auditor Date Signed
' i :.
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990 1990 Pay 1991 1991 Pay 1992 19 — Pay 19 _
Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 7/2 Homestead Lesser of 1/2 Homestead
Valuation or $2,500 Valuation or $2,000 Valuation or 51,500 Valuation or 51,500
_ I - _ i
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