Homestead_Sermersheim Slut FORM 5'1e RU WO TREASUILDI 101131 TS-1A
.Vrnw'EO BY CraTE enAmmi Arrotz s.`1 n PlUXR1am BY air DEPARTMENT OF LOCAL CAs'=RYMFA'r FINANCE M 4.I.1-224.1
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 cm for homestead fraud.Homestead fraud causes higher tax bills for all therefore.
HEA 1344--3009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recebe the
I L E D benefit and to provide additional idtntifyine information and necessary to allow count'go d county to better monitor homestead
filings.This iofnmutinn will be kept confidential and can only necessary
accessed by authorized count'officials.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
APR 1 3 tuned Taxpayer Name Property Address
Sermersheim, Dean A/Heather N
/�tri!f. 204 E Oak
GIBBON COUNT AUDITOR
Princeton IN 47670
Dean A Sermersheim
204 E Oak State Parcel Number Legal Description
PRINCETON IN 47670-1610
1.111111111111111111111 11111 11111111111111111111111 26-12-07-201-001.802-028 019-01802-00 WARNOCK 5 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 I First Middle r Last
aEfv,1 A• sERrc ftsr1ErM
•tg Address(number and street,city,state,and ZIP code) ® Same as property address
Spouse First Middle It
i-len iAaR o Si RmEHStlEt t (�
Mailing Address(Number and street,city,state,and ZIP code) ® Same as property address
- — - - -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 1 Signature Date
•
�. ; CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
Sla�e F«m 5473 (R6I403)
Prescribed by the Department ol Local Govemment Finance
INSTRUCTIONS: See reverse side lor filing insWctions.
FO YEAR
� = NC
i nN 0 4 2005
� cwe� 'll ps r`� r� e4t k-e r U2 Ir m P r 5 h e i n1�e�y �dR� ��'�r�,,. Zo
I(We) occupied as our principal place of residence the following described real property for which a Homest��tlp��i�t is hereby daimed:
�I (We) owned ❑' Are buying under contract
Have a bene5dal interest in the enlity �hat is liable (or ihe property �axes on the property and that owns the property or is buying under a wnVaU.
If buying om m�uaa, Fee Simple owners name
wnUaq is recorded
Counry
Tavnship
Parcel numher �egal escri tion
O 1�-�� 8b a-4� � �l�o� r h o�L
If any ponion of the resitlential shucWra w t�e land na excaeding one (1) aae tliat
of Ihe proD�Y uL7izetl to produca inwme.
County
Tavnship
I hereby certify the above statements are W e, corted and complete.
aM streef, cil}; sfate, ZIP coda)
Rewrd number
Tacing �iqt fciry, mwn, tawnsAiP)
Page
_ I Is the property in question:
❑ Real property ❑ MoWle Homo (I.C. 61.1-�
surtounds Nat sLUCture is used to produce income, describe the use and portion
Couniy
Tavnship