Homestead_Nurrenbern (3) RATE FORM.)NnL'rwn TREASURER FORM 75-IA
..rrRCWEO BY'ME BUM Of MTVn:NTS.:in rtf9(Wam BY THE aEPARrtrYT OF[(CM.GOVERNMENT FINANCE MS-L.E::R.I
101 N lain y Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N rrAain
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this dedttaion becomes
more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
• HEA 1341-2009 requires tatpasers who receive the homestead standard deduction to verify that they are eligible to reecho the
benefit and to provide additional identifying infomaton nectars,-to allow county government to better monitor homestead
filings This information will he kept confidential and can only Le accessed by authorized county officials.The Depanment of
Local Government Finance will use this information to create tads that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Nurrenbern, Kenneth L/Wendi G
RI Box 304 A
Francisco IN 47649
1838
Kenneth L/Wendi G Nurrenbern
2706 S 550 E State Parcel Number Legal Description
Francisco IN 47649-9105
I I I I uI I I I I I I I I 26-13-30-100-001.470-004 002-01470-00 PT W NW 30 2 9 3.16 AC
un
-- v t o nr t rat n t h r r rt r t tot n a tr _ _—.__ X D�10
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
Owner I First Middle Last
hthh � Nvr�eh6�rh
Tg Address(number and street,city,state,and ZIP code) %Same as property address
aloe S 55_ vE
Spouse t�j �^ First Middle �y '/ ��1 /^n yy 1 Last
ka tt Q l V Vr�a`.-'cY t om/Ccc
Mailing Address(Number and street.city,state,and ZIP code) Smne as property address
47,06 S 557) E-
---^-�-- '- -'`- ---`
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 1 Signature Date
111
•
CLAIM FOR HOMESTEAD PROPERTY TAX
a CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 15-92)
s INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC70
n .
CERTIFICATION STATEMENT t ! L U
n
I (We) c that on the 1st dayilof N h, 19
1 (We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is here4,c)aiu��
❑ l(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 under a contract.
CONTRACT RECORDED
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded -
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township)
P ce umber
A
Legal description
o- _
any portion of the residential structure or the land not exceedi g on (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of
the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES _
County
Township
County
Township
.,reby certify the above statements are true, correct and complete.
ig rWf
ig r of claimant'
re in
street, city state, lP
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(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 plus line 7)
(8)
1 hereby certify the above is true, correct, and
complete.
Signature of Assesor
Date signed
verifying aclion - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
Valuation or $2,000
$
Signature of Auditor
Date signed