Homestead_Wellmeyer 1 StMt FORM!).W IR I 1 ThLSSUREA FORM TS-1A
.APPRINE0 BY MATE 1 00E.SR]LNTS.9v lllrnm muY MC BEPAATMEIT OF Lh'AL G VEELM'XETl FINANCE MH.I t 4.1
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 deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than eser for homestead fraud I lomesreal fraud causes higher tax bills for all:therefore.
• FIFA 1344-2000 requires taxpayers who receive the homestead standard deduction to serify that they are eligible to reecho the
benefit and to provide additional identifyine information necessary to allow county goverment to better monitor homestead
filings.This information will he kept confidential and can only he arses sed by authorized county officials.The Depanntenl 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
Wellmeyer, Jerry V
7282 F SR 64
Francisco IN 47649
4642
Jerry V Wellmeyer
7282 E SR 64 State Parcel Number Legal Description
FRANCISCO IN 47649
26-13-20-200-001.479-004 002-01479-00 PT SE NE 20 2 9 4.21 AC
X' C-1-D-7
PART 2:TAXPAYER INFORMATION
Owner I ----�� First / Middle /,,,,�/ Last
c 7 r 1/ �TOr �" ///06 yer
•ng Address(number and t,sty,sate,and ZIP ode) — -- -- .K Same ns property address - — - --- _. '
72 9 E —Sx t Nei 6").z/ ,d r c.Ls ro 2z< c/77 r9
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) E Same as pmpeny address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Sem
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 may be liable for back taxes and substantial financial penalties.
Owner I ignatre Date
•
CLAIM FOR HOMESTEAD PROPERTY TAX FORM PEAR
} CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (Re 14-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) certify that on the 1st day of March, 20_
occupied I (We) d a ur princi I lace of res5iA t pe the ollowing described real property for ich a Homestead Prop Is hereby claimed:
(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 o76suz dn E ar C
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded
Record
`3' z .. ,f'r• +gxt•
arcs' alb -.i a„' �5 :'sP,ROPERTY`DESCRIPTI.._..i*q `
County
Township
Taring di 'c city, town,
gpTOWm`�
O
Legal description �7 s e property in question:
N (, er — G�-Ieeat property ❑ Mobile Home (I.C. 6-1.1 -7)
H any portion of the residential structure or the land not exceeding one (1) acre that immediatety surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce incerne. /c �11
:- "` -+�'� __:�.�'�' ?tat- i��• �-' ��`. �P, ROP .ERTY;OWNED.BY'CL''AIMANT;IN': OTHER` COUNTIES,±`. �: ��_ �; ��`" �e�� "�'= `�.c«'= 'E�.�- }s'•''�i�B
County Township
I hereby certify the above statements are We, correct and completed
Sig ture of clai ant
leer t, st te, code) �� L W �Il CO�-Ig
--Yr } ''�ASSESSOR�UB E O Y3r
TRUE TAX
ASSESSED VALUE.HOIdESTEAD
NON= RES)DENTIAL '%'+
VALUE��
ATxlllo� OFTTVy
VALUE
r.Lr..:.VALUEsa°.',s"`
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
_..
Other land
°- 4 :' -'?
(2)
a
Total land (line 1 plus line 2)
(3)
Dwelling
(4)'
K-5"'i�� l ri" xN ",
- 3x,33,`3 -�'
�.1��,r•.'t
Residential Improvements or Annually
Assessed Mobile I Menuf ictured Homo
Garage
3"'ma:si{A.�....
+_t'
= 'p des 1 :^ vt=` -x
()
_
{
Other improvements
(6)
WE
Total Total improvements (line 4 through line 6)
(T)
Total value (line 3 pits line 7)
(e)
I hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
Signature of Auditor
20 _ Pay 20 _
Lesser of 112 Homestead
valiption or 535.000