Homestead_BaehlCLAIM FOR HOMESTEAD PROPERTY TAX
s CREDIT /STANDARD DEDUCTION
r State Foos 5473 (82/5-92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM
HC10
( aollUnr ,:L !nc,:, r+osslo
YEAR
CERTIFIC TI STATEMENT
f�
I (We)
(r fh, on the 1st ay of March, 19_
I (We) occupied as our principal place of residence the follo n described real property for which a Homes
rbdey TaX Eredii is hereby claimed:
❑ I (We) owned El Are buying under contract
❑ Have a beneficial interest in the entity that is liable for
,,/� p'��
the property taxes on the property andihat6wn' its
to . i ng under a contract.
CONTRACT RECORDED�P'ELA�
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxin district city, tc mwnship)
Parcel number
Legal descrip(ton
70 -�
`j,
/
If any portion of the residential structure or the land not exceedi
one (1) acre that immediately surrounds that structurd is used to produce income, describe the use and portion of
the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
tereby certify the above statements are true, correct
and complete.
Sign a of daimant
Address (number and street, city, state, ZIP code)
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Otherland
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assesor
Date signed
complete.
verifying action - Signature of Auditor
Date signed
.
STANDARD DEDUCTION ALLOWANCE
19 Pay 19 _
-
Lesser of 1/2 Homestead
$
Valuation or $2,000
Signature of Auditor
Date signed
STATE FORM 53K IR'!■NI TREASURER NORM S:A
APPROVED BY STATE WARD Cif Arkin ic.eon PtrggNarnnY THE DEPARTMENT OF ICA'AL COVttNMrA'T FINANCE IC 11-1.14.74.1
GitronCoJntyAuditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction beconses
sa more beneficial.there is more incentive than ever for homestead fraud Ilomestead fraud causes higher tax bills for all:therefore.
HEA 1344-2039 requires taxpayers who remise the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifyine information necessary to allow county government to better monitor homestead
fling.This inforrntrinn will he Lepi confdeniial and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create trots that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
-- Baehl, Clemens A/ Mary B
CORNIER Third&Church
Ilaubstadt IN 47639
8132 C
Clemens A/Mary B Baehl !�
400E Church St State Parcel Number Legal Description
Haubstadt IN 47639-8211
l��ttr�r��tt tt��I�I11111111111111 tt��ttt����lt r�11111111 t� _ 26-19-31-101-000.709=009_013-00709_00 ELDERS NEWMAN 14
— �t�r
7(
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
CI.- EmEn i3,q & HC-
�g Address(number and street,city,state,and ZIP P tale) u Same as property address
HD& E CifupCt! ST1 f-/,,9a %gtcT , _TN g76s1
Spouse First Middle Last
// 4 t 2 y 8 a NAE ru
1-
Mailing Address(Numb&and street,city,state,and ZIP code) s Same as property address
o 0 E. C y N ugC CT.� f
y 14 Lgsrgp7 u L/74c39
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
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PART 4:ADDITIONAL INFORMATION
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