Homestead_SchatzR CLAIM FOR HOMESTEAD PROPERTY TAX
= CREDIT /STANDARD DEDUCTION
S State Form 5473 (R41 8-00)
INSTRUCTIONS: See reverse side for filing instructions.
I (We) 1
I (We) occupied as our prindpal of residence the following described real property for �which a
I (We) owned ❑ Are buying under contract
7 IN& X
r
certify that on the 1st day of March, 20_
stead Property Tax Credit is hereby claimed:
beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
ONTRA6TRECORDED` _?'Ewa','r..:.,.°_- rrL`_",..�s�
if buying on contract, Fee Simple ownefs name
Recorder's office where contract is recorded _. Record number Page
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.,.,,�
��PRQP ,ERTYi�DESCRIP�TION��R�°�''t* _
County
Township
Taring district (city, town, township)
Parcel number
Legal description
oZ S- 71k',eal Po.aox.27K I't c r5 co- z,A1 4iz&q1
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3
Other land
(2)
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.
- -
�' -
13
r`'�"°PR'OPERTY�011'JNE�DrBYLCLA_
..„
NTr.I_N':-OTHER•C_ OUN7IES .;,,.._' "�--,a �u'`*',_
County Township
County _
Township
I hereby certify the above statements are true, correct and complete.
Signatu of claimant
'ress (number and street city, state, ZIP code)
oZ S- 71k',eal Po.aox.27K I't c r5 co- z,A1 4iz&q1
y .,•.t .�.nssrs' + +. s .'F .c
_,. �i ASSESSOR USE.ONLYa K>
..,.�.
a°" "°'
TRUETAX
FUEte }`ATi10�0%FOTN
Y "SESSE3r.. U—E
ASSESSED;VALUE
o s
� .—
n HOMESTEAD
VALUE....2a';..
- a.—• ..zR
FaFAN;-RESIDE! U. -
- VALUE.'
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
$
Valuation or $6,000
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3
Other land
(2)
Total land (fine 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
ME }= q
Garage
(5)+
-t " =+
Other improvements
(6)
-.-0
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(S)
hereby certify the above is We, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
STAN1 ARD.DEDUCTION
�
20 _ Pay 20
Lesser of 12 Homestead
$
Valuation or $6,000
Signature of Auditor
Date si
6 'V I
STATE FORM 53569(R3A-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.1-22-8.1
_t) IMPORTANT NOTICE TO HOMESTEAD;PROPERTY.:OWNERS -''
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 ever for homestead fraud. Homestead fraud
',causes higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers 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 filings. This information
will be kept confidential and can only be accessed by authorized county officials. The Department of Local
Government Finance will use this information to create tools that will help county officials eliminate
homestead fraud.
- - J•: .PARTITPROPERTY'NFORMATION . •' a
Timmer Name Property Address State Parcel Number Leeal Descnntion: ,
Herman 0 Schatz III 202 S THIRD ST 26-13-19-202-000.149-005 OLD PDeLAN 58
FRANCISCO IN 47649
•
Complete and return to: 12111gIlillMI110llfllll fllIIllAlll]II713lf'1!119i1111ai2 -
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
"' .. PART 2: TAXPAYER INFORMATION . "Ii''..4" •">:
Owner 1 First Middle Last
%rrirn-J O 773 • SC-Led-4—ding Address(number and street aty,state and ZIP code)
Same as property address
f o. ZoA Z7b' 2o2 5. 7A;al firANC1S CO = ,d • x/76 9?
spouse First Middle Last
Cl;r;5 Irk a Lee SCI.c f-- z
Mailing Address(number and stredt_city.state and ZIP code) - I 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
-,,: :.,.:.,t),„..: •- _:'' ,„'7 ;,'z:PART4:ADDITIONAL INFORMATION, i. .,1-,-F.} t" : 5- :: .:v ;
'FILED
• DEC 27 2012
CID60N COUMTY AUnlTC1P