Homestead_Koberstein (8) : + STATE rnI.%i ,R:/YYI TRFAxeamR FORM 73-IA
• ..rrwmED m SILO;110111001:MU UN SUn PRESCRIBED BY nn:DEPARTN Vr OF LOCAL rtVELMMEFT FINANCE R1i.l-:]4.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 deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than eser for homestead fraud I lomecead fraud causes higher tax bills for all:therefore.
HE.\ 1344-2009 requires taxpayers who receive the homestead standard deduction to verity that they are eligible to Freebie the
benefit and to provide additional identifying information necessary to allow county gocemment to better monitor homestead
filing,. this information will he kept confidential and can only by aeeecsed by authorized count'officials.The Depanntent of
Local Government Piwncc will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
—.— Koberstein, Kenneth R
501 N Gibson
Princeton IN 47670
2675 — - - - __ - - — — _—
Kenneth R Koberstein
501 N Gibson State Parcel Number Legal Description
Princeton IN 47670-1723
1,111111111111111111111 Iiltrtlrrltlrrlltll Ilrrltll 26-12-07-201-003.423-028 019-03423-00 OLD PLAN 101 PT
. PART 2: TAXPAYER INFORMATION
Owner�rII 1/ First - Middle 141? Last
" tg Addrea,(number andsncct:eity;state:and ZIP code).___/ ____ _ Mr-Same ea property.addTec; _ _ __ __
sof Al, 6 /&con Si; Rvneefon .D4 4/71t 2D
/
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
Stine .
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 Signature Date
•
� R,R
e� � Y CLAIM FOR HOMESTEAD PROPERTY TAX F E
���'' CREDIT/STANDARD DEDUCTION • ►tC�o
.,�.`;� State Form 5473 (R2 / 5-92) ' '7
?ei� -
INSTRUCTIONS: See �everse side for liling instructions. lj �
��+.RJ �
' ' " - � CERTIFICATION STATEMENT�
,1 (We) certity that on the 1st day of March, 19 7✓
��) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
I(We) owned ❑ Are buying under contract
Have a 6eneficial interesi 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 �
It buying on contract, Fee Simple owner's name . • . �
Recorder's office where wntract is recorded Recortl numher Page
� - � �� PROPERTY DESCRIPTION
County '� , Township � Ta�cing diSViCi ry own, fD�+'n5hip)
legal
V � 1 U�� O: � UU � i�(.Xi..t r X�: � U� ��
It any portion of the residential strucmre or ihe land not ezceetling one (1) aae that immediately surrountls that structure is used to produce income, descnbe the use antl portion
ot Ne pmperry uGlizetl to protluce income.
ASSESSOR USE ONLY �, � TRUE TAX ASSESSED HOMESTEAD NON-RESIDENiIAL
. -. VA�UE VALUE VALUE VAWE
Land not ezceeding 7(one) acre immediately
surroundinq residential improvemenis. (�) �
Otherland (2)
Total land (line 7 plus line 2� (3)
Dwelling (4)
Residential improvements
Garage (g)
Other improvemenis (6)
Total improvements (line 4 through line 6j (7�
Total value (line 3 p�s line � (g)
I hereby certi�y the above is We, correci, and Syna;ure of Assessor Date si9netl
complete.
��=rifying action - Sgnature oi Autlitor Date signed
STANDARD DEDUCTION ALLOWANCE �
19_Pay19_
Lesser of 7l2 Homestead
Valuation or 52.000 S
Signature ot Auditor . Date si