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Homestead_Burkhardt surf FCIRNI: e.BC'r P0" • TBFASULER FUCAi-1A APPROVED BY SUTE BnSPD Of MYYa:Ans.a,n PtFARInmD BY TM DEPARTMENTlfLOCAL CAVttNMrT'r FP:ASCE IC 6-1.1224 I Gibson County Auditor — 101-N•Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard J ii lion.As the receipt of thix deduetiowbeconies more beneficial,there is more incentive than eser for homestead fraud Ilomesteal fraud causes higher tax bills for all:therefore. - • Ill HEA l344-3009 requires taxpayers who receive the homestead standard deduction to verity that they are eligible to recrixe the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filings.This information will he kept ennthlential and can only be accessed by authorized county nficials The Department of Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION _ Taxpayer Name Property Address _ Burkhardt, Harry A 1031 S Prince ST Princeton IN 47670 3676 Harry A Burkhardt 1031 S Prince St State Parcel Number Leila! Description PRINCETON IN 47670-2629 �t� u�n t�t�u nt�t�t�I �t��t�u n��u u��u��t� k 26-12-18-102-000.290-028 019-00290-OO SS ADD 31 nllntltll PART 2:TAXPAYER INFORMATION Owner I First Middle Last fa i r! r L r,//`'�l - 7 I. /Iv"a2 'Dg Address(number and street • state,and ZIP code --- - - - - - .me as property address - - -- - - - - / 3/ gl(Ce 57, bides -6a/,�7� Spouse First' Middle Last • ..-_______. Mailing Address(Number and street,city,state,and ZIP code) CI es Same as property address - ,...----_ Social Security Number(last 5 digits) Driver's License/State ID Num r (last 5 digits) Other(please specify in Part 4 below) -- - — -- --- , sX —=-1772.7 / ' —. - 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 eliuible to receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions unlaufitlyy,he or she may be liable for b to taxes and substantial financial penalties. ��tgnamre Date i• . 1 ii I\ pa �*_�•� a� "°Y CLAIM FOR HOMESTEAD PROPERTY TAX ���!� CREDITISTANDARD DEDUCTION `.,.,�,';� State Porm 5473 (R2/ 5-92) �S7 INSTRUCTIONS: See reveise side 1orliling instruc(ions. 3 n � { � .- � �_ �: II'� :� a •.; S'e) � f(�,QA��(���,yj��,�,(L� .( certify that or��[1�f�f8lPAarch, 79_ I� We) occupied as u rincipal place of residence ihe tollowing described real property for which a Homestead Property Tax Credit is hereby daimed: � I(We) owned ❑ Are buying under coniract �, . ❑ Have a beneficial interest in the entiry ihat is liable for ihe property taxes on the property and ihat owns the property or is buying under a contract. � . ,CONTRACTRECORDED - If buying on comract, Fee Simple owner's name - � , Recorder'S oRice where Contrac� is recorded Retord number Page " PROPERTY DESCRIPTION Township Legal It any ponion of the residential sirucWre or the land not exceeding one (7 � acre that immetliately surmunds thai strucWre is o( ihe property utilized to produce inwme. '" � to produce income, deunbe the use antl portion ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL VALUE VALUE,: VALUE VALUE Land noi exceeding 1(one) acre immediately � surrounding resideniial improvemenis. ��) _ Oiherland (2) Total land (line 7 plus line � (3) I Dwelling (4) . Residential improvements . Garage (5) � � Other improvements (6) Total improvements (line 4 through line � (7) Total value (line 3 p�s line � (g) I hereby ceRify ihe abOVe is [rue. Correti, and Syna.ure ot Assessor Date signetl �plete. c �ing action - Signature ol Auditor Date signed 19_Pay19_ Lesser of 1l2 Homesiead Valuation or 52.000 STANDARD DEDUCTION ALIOWANCE 3 �