HomeMy WebLinkAboutHomestead_Schafer (12)CUllf�i FOf� fiCi��SlEf�U Pf�PERTY Tlll, C��IT FOR 'iiAR 19��
5[E BJ1CK FOR FIL1PlG Ih1S1RUCTIOidS
I, �`„+e) m ,`1r�t..Q� `{' / IC114M� . certify that on the lst dal c�
1+<zrch, 19 1�, I, (P1_) cv-cupied as our princioal olace(�br re>iden� t}�e follvuing ds¢i�d real
r�ro(y'rty for �•%hich a Ifairpst_ad �op°-rty T�c C.Yeclit is hereJ�p tp.ing claiirc�ci:
1�:;>> .v�� �b� _ � � � 3 s
� are bu;�inn urder contract
� hace a}p.neficial interest in the ta>�a}°er (�
Froc^rty L>>scrin`ion in �', (`� ���tY `�,.�� lAh�.. 'lt�,z�:tii
T'a: ing District (City, Ta:n, 1b'�v'i15lllp� :
P�c�l Iliu�il.�s or legal des¢ipFion s}r.nm on tar, stat��n�it:
.�-� e+�� S���y 3o-a-�a I•1y
I= bu�.-ino on �ntract: Uh'n_ss nan� (f°-° siurrole oc•m_r)
Contract r�ord�3 in P_°o�rd_r�s Of�ice - P�ard tb. �'a9°
Z_` ��y �ortion of �}te residential structure or t]ie land, not a��e�iing one (1) acte tltat
imr.-�diately suLZOUrr3s that struc�ure is user3 tn produce inca�, descri� t1i_ us_ arri rortion o�
tiie nroe�sty uti lized to procluce ircorr�
Pn�i� other �wities in o:hich inni�zdual c::ns or is buying real orop°�t}': �17f1t'y' `I17:'75IliD
Z h:seh}' c:rti�y the abow staternnt is true, c�rre::t an3 ��� lets.
. xSianature r Street I��ress Cit"�, State aid Zip Ccu:
*Inciividual eit}r�r c..°ns or is b�}�iiig wter a mntract t}tiit provides he is tn oay t1�_
p,-o �`"' s on t} resid��ce, or t�as a ben�ficial int�sest in t}� tiar.wyer.
`� � � � � - FOR ASSESSOR�S USE Oh�LY -
MAR 19 1°86 �� casn rUS�55� F���st�_:.
Valu� Valu3ticn Val��a`i^:
L��:� not ` c�e�.�ng 1(t ne) racre increciiately .
� 1�
surrourr3ing re i'denti!al�.?m� rov�rr��ts
/.'_ DIT�„'
or��� v�
'i'otal Latid
Pesidential 7irprovQr�n`s avelling
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(2) / F�D
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(4)
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O;��er Ic�mro'+an�nts
(7) `t o
7� ' IJ�ro-d�m�ts - Lins (G) plus (7) _eauals (a) (B) �0 3 /o
I hs�y c�,iiy ttle abo�-° is true, correct, arx] wrml�te.
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SfATE FORM 5)S69 (R'JB-09)
MPROVED BY SfAiE BO.VtD OF ACCOU�TS, ZOD9
II TRFASURERF00.\1TS-IAI
PRESCRIBED BY THE pEPNtTfE\T OF LOC.LL CA�'FJI.�1T:fI'�IHA.V'.'E IC61.1-+_2-8.1
lndi��iduals and married couples are limited to one homestead standard deduction. As the receipt of this
deduction becomes more beneficial, there is more incentive than ever for homestead fraud. H'imestead fraud
.eauses hig6er tas bills for all; therefore, HEA 1344-2009 requires ta�payers who receive tti�e homestead
standard deduction to verif�� that they are eligible to receive the benefit and to provide additiunal identif�'ing
information necessary to allo�r counh� go��ernment to better monitor homestead filings. This information
will be kept confidential and can only be accessed b�� authorized counq� officials. The Deparr:ment of Local
Go�•ernment Finance will use this information to create tools that �eill help county officiaNs eliminate
homestead fraud. '
1 . • � � s ♦ • M . ll � . . n . � . • . ...�.. .� �iJ:�.M>.."'9Y..."919M%WlN 'L�If19.�
Taznaver �ame
Michael R/ Norena J Schafer
Conrplete and return ta:
�� ,
Sacial
state
Pronertr Address
0 U$ 41
PRINCETON IN 47670
Sta�e P:vael \umber
26-12`-30-3/00-001.73i-0?7�
G
Leeal Desarinli(��
I
PT S S W 30:! I 0 I.14 AC
mi�iiui�ru;im��mmiriimi���iioir,�miiiiio�i�irumiiiii�
GIBSON COUNTY AUDITOR, ]01 N p1A1N PRINCETO\ IN a7670 �
First
(number end street city, state. and ZIP codc)
5 disu) " I. ihivcls
�
�
�iling Addrcss (I�umber and sucet city, sEate, and 7.IP cade)
`-/-'
5
Drivcrs Licensc/Statc ID
�!
Sta:e ID Numba� (last 5 digits)
5 digits)
Mitldle
I
Same as property address �
wie otnx (Weau spedy in'.I en 4 ee�ow)
� � _---- �---L--� - ---�_..
$ame az P� � �� �
�OtLer (plcax spxify in Psn 4 bclow)
APR18'T.011
s�
s�,v����a
� Samc as pmputy addras
undersigned certifies, under penalty of perjury, that the above and foregoing infonnation is We and correct and that he or she is eligible to
re the homestead standard deduction on this property. Each undersigned also understands that, by claiming additional tiomes[ead deducrions
�fully, he or s6e may be liable for back ta�ces and substanaal Snancial penalties. �
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