Homestead_Koberstein (9) .. - 515TE FORM!Oen OW Pan) TREASURER FORM
BOARD OF Arts,IVES PREMREDDBI'nn DEPARTWYr(4t&AS rfo£RHMrKT FINANCE l('ILIA-224.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[.tomes
more beneficial,there is more incentive than ever for homestead fraud.I lomestead fraud causes higher tat bills for all:therefore.
HEA 1341-2069 requires mspayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing.This information will be kepi confidential and can only k accessed by authorized county officials.The Depanmem 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
Koberstein, Marion B/
PO Box 56'1
• e on IN 47670
3237
Marion B/ Koberstein
1006 Wilson Ave State Parcel Number Legal Description
Princeton IN 47670-3136
es 26-12-08-201-002.203-028 /019-02203-00 DIKE ENLG TRACT
t I II r It II 11I nt III II nu II u II II n I I t t II teI t II
68I67I69PT
s — °_ Middle Last
Mailing Address(N)umber and street,city,state,and ZIP code) ® Same as property address•\ c -' •N4( \
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 Signature Date
\ \7-k. ._5.J \tee - `� a�s_�.{ a� ICA \\\c*�
warn Mc io im9
PrescriheE By Stale BoarE ol Ta. Commiuioners
Ta & FileO in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CHEDIT FOA YEAR 19� ✓
_ �_ �^ FOR_FILING INSTRUCTIONS O�(�_ oaa o3' ��
�(We) -��v v • � ���� � certify that on the 1st day of
�darch, 19� I, (We) occupied as o�r principal place of residence the following described real property for
which a Homestead Property Tax Credi[ is hereby being claimed:
I, (We) C'f"owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in �' bso;-� County aa-�ka- Township
Taxing District (City, Town, Township): •�ri /lc e i-'�c n �
Parcel Number • or legal description shown on tax statement:
1._
If buying on contract: Owners
�fee simole owner)
Contract recorded in Recorders Oftice - Record No. Page
a—ia
�s�/3
If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that
structure is used to produce income,'describe the use and portion of the property utilized to produce income
Any other counties in which individual owns or is buying real property: County Township
� her y certify above statement is true, correct and complete.
�� � o�L y
gnaW. Street A dreu Ciry. State ana Zip CoGe
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceedingJL(or� �E't'2 f}4fine iately
surrounding residential improvement
other �and �1AY 2� j�79
Total Land
Residential Improv�� AUDITOR Dwelling
Garage
Total
Other Improvements
T�-'" Improvements - Line (6) plus (7) equals (8)
I�by certify the above is true. correct. and complete.
OI FSSC550�
App
�/� ',
I
True Cash Assessed Homestead
Value Valuation Valuation
i /9�
(i) Lo�.o
(2)
(3)
(4)
(5)
(s)
(�)
($)
- ACTION BY AUDITOR -
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Date:� � �f, l% 79
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