Homestead_Memmer STATLIORNIf3N.Int.400 TIEASU[UR FOLV:NA
xnwr. IMPORTANT NOTICE TO HOMESTEADrP PROPERTY~OWNERS L4
Gibson County Auditor
101 N Main
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.Ilomestead fraud causes higher tax bills for all:therefore.
HEA 1337-3009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receve the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools Mai will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Memmer, David/Alechia J
RI Box 54
Oakland City IN 47660
1673
David Memmer
R1 BOX 54 State Parcel Number Legal Description
OAKLAND CITY IN 47660-8638
26-13-13-300-000.058-006 003-00058-00 PT SW 13-2-9 2.58 AC
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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 • Last
MO■\F AT2I I m er
®ag Address(number and Stray.city,state,and ZIP code) g( Same as property address
I oS?S E D S S 0O.Klan� C;4- 0 0
Spouse First Middle Last
A l eekt of lea r Me_trt m er
Mailing Address(Number and street,city,state,and ZIP code) (kirSame 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 I Si§nan re Date
•
Z rr or CLAIM FOR HOMESTEAD PROPERTY �TA.V-1o, CREDIT/STANDARD DEDUCTIONState Fm 54 73 (R6 / 4-03)
Prescribed by the Department of Local Government F;rand
INS TRUC FIONS: See reverse side for filing
FORM YEAR
HC10
ertif that on the 1 st day of March, 20
ied as our principal plat of residence the following described real property norwhic;; maomesteadyProperty Mkrefi i3hg@McIaimed:
our p
d
as
'W: ' �o
� ;(Wa�
I
I (We) owned ❑ Are buying under contract
Have a beneficial interest in the entity that is liable for the property' taxes on the property and that owns the property Q,gdw,a contract.
"CONTRACT!RECORDED-=5 ti�?-'..;4��-'t
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
County Township Testing dist l(ailyto I Vtownship)
_U0 Legal description Is the pro u stion:
Go I it�R. property ❑ Mobile Home (I.C. 61.1-7)
If any portion of theresidential 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.
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0k(50.EfkTir.6wNE6BY if
County
Township
County Township
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hereby certify the above statements are true, correct and complete.
S attune ofd imam
ss (number not street, c4 state, Z 5 code j
tkgaet�d Z/ V 7(a 6 0
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--YASSESSOIR USE IONLY - ik,
:—TRUETAX�'1:'-j
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,
AiSd��6 iY�uh
��;HOMESTEAD -`'---;'
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Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
a-N
Total land (line 1 plus line 2)
(3)
R
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
(5)
4 . . . . . . . . . .
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
I
Verifying action - Signature of Auditor
Date signed
--STANDARD.DEDUCTION'ALLOWANCE * -t
20 Pay 20
Lesser of 112 Homestead
"uauon or 535.000
Signature of Auditor Date signed