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Homestead_Reinhart MATE FORM!11 11C/s-rv1 TRFASUMI FORM 73-IA ATPROVEt BY SISTE BOARD Or MTrtlTs.21.N PRESCRIBED BY air BEPARl'c'r OF LOCAL Cow"stNMrwT FINANCE tc•-ii-rat Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and married couple arc limited to one homestead standard deduction.As the receipt of this deduction becomes Amore beneficial,there is more incentive than net for homestead fraud.Homestead fraud causes higher tax bills for all:therefore. IIIP HEA 1344-2009 requires taxpasers who receive the homestead standard deduction to verity tlut they are eligible to reeene the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filings.this information will be kept confidential and can only be accessed by authorized county officials.The Depanment of Local Government Finance will use this information to create tools that will help conty officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Reinhart, Pamela D 230 Adams Princeton IN 47670 1264 Pamela D Reinhart 230 Adams State Parcel Number Legal Description Princeton IN 47670-2208 IIIIIIIIIIIIIIIIIIIIIII uniV t ll r I I I fit I nI or I I r I I 26-12-08-301-001.822-028 019-01822-00 LYNCH 2ND 123 PT/122 PT This form MUST be returned to County Auditor's office. Please do NOT send this form back with your tax payment to the county treasurer. PART 2: TAXPAYER INFORMATION Owner 1 First fA ', Middle Last / TED-�.l t'( DAR4._ /JrC Retniff/X-r-- fig Address(number and street.city,state,and ZIP code) Same as property address 0?3 O S, gall/MC S74 /in.;t -.,v =N. 5z7G,7a 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 Licensc/Stare ID Number past 5 digits) Other(please specify in Pan 4 below) sox 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 l Signature Date e�� "�� a CLAIM FOR HOMESTEAD PROPERTY TAX YEAR ;��'= CREDIT/STANDARD DEDUCTION H o �;,;�� State Form 5473 (R2 / 5-92) " - ,." ���N 2 5 1994 INSTRUCTIONS: See reverse side lor filing instructions. � CERTIFICATION STATEMENT � � AUDITO {? � �) . /i-ii%�� certify that on the 7 st day o�f ?.iarch, 79_ �) occupied as our principal place of residence the following desc.ibed real property for which a.HOmestead Property Tax Credit is hereby claimed: ,�I� I(We) owned ❑ Are buying under contract L� Have a beneficial interesl in the entity that is liable for the property taxes on the property and ihat owns the property or is buying under a contract. - � CONTRACT RECORDED - � If buying om m�tract, Pee Simple owner's name � � - Recortler's office where contract is recortled Recortl num6er Page County Parcel number Ita��� of the pmperty i legal simcNre or the ice income. PROPERTY DESCRIPTION � Taxin i tric� (ciry, town. '4 �//YG'�� '.0 �.t,ro �o7a,rJ one (1 � acre ihat immediately surrounds tha� used ro prodJce income, desaibe the use and portion PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES Counry Township Counry Township �aby certify ihe above statements are irue, correct and complete. Signawre o( claimam Address (numberandstreet, city, state, ZlPcode) a .J . ��,u — �7 ASSESSOR USE ONLY ,.� TRUE TAX � ASSESSED HOMESTEAD NON•RESIDENTIAL � - VALUE VALUE. VALUE VAWE Land not exceeding 7(one) acre immediately surrounding residential improvements. ��) ' Otherland (2) Totalland Qine 1 plus line 2� (3) Dwelling (4) Residential improvements Garage (5) Other improvements (6) Total improvements (line 4 through line � (7) Total value (line 3 p�s line � (g) 1 hereby certify the above is irue, correci, and signamre of assessor Dare signetl complete. ��-ing aaion - Signamre of Audiror Date signetl 19_Pay79_ lesser of 1/2 Homestead Valuation or 52,000 STANDARD DEDUCTION � Dare signed