Homestead_BetheAr
} CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
I (We) / /% G ( \, %C� i`- /jL / C/, �,C certify that on e 1 stayrch
(We) occupied as our principal plaodof residence the following described real property for which a Homestead Prop. ax Credit is hereby plat d:
❑ I (We) owned ❑ Are buying under contract V 1 -) LU UJJ
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or buying under a contract.
' fYJ , 411D1
CONTRACT.,RECORDEO .nom-
If Duyutg on conbad. Fee Sunple owners name
Recorder's office where contract is recorded Record number Page
PROPERTY, OWNED BYCI 'AIAIANT- IN'OTHERCOUNTIES
County Township
County i
Township
Testing distri t 'ty, town, wnshi )
1
1-6 t
6r �.
P pet mber
�tJ Z —00
CC \
J W �— 3 — O
Is the property in bon:
Real property El Mobile Homes (I.C. 67.1 -7)
H 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. r f _
-1 ti
PROPERTY, OWNED BYCI 'AIAIANT- IN'OTHERCOUNTIES
County Township
County Township
I hereby certify the above statements are true, coned and complete.
Signet re of claimant
Address (number and street, city, state, ZIP code)
- .ASSESSOR USE ONLY -- y¢
-TRUE-,P&'4 % i
ASSESSED VALUE
�T�100 %'OLLF�ITV�
, HOMESTFAD+
"ir..VALUE�
�NO ESIMr.'
�. r�- t�aVALUE -,=
Land not exceeding 1 (one) acre immediatelyrw
sYiy-
surrounding residential improvements.
s
Otherland
(2)
r
Total land (line 1 plus line 2)
(3)
Dwelling
(4
Residential Improvements or Annually
Assessed Mobile / Manufactured Home
Garage
Other improvements
(6)
Total improvements (line 4 through line 6)
(T)
Trial value (fine 3 plus line n
(S)
I hereby certify the above is true, coned, and
Signature or Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
Signature of Auditor
20 _ Pay 20 _
iser of 12 Homestead
/eut}Lon or 535.000
5
STATE FORM!wit R/.tY1 LYIAlllrf]I PORN:11A
APPROVED BY Sr4E NTARDOT M11TINT5.IVM Parn[1Upm BY TIE DEPAnner OF LOCAL CAVERNMTNT FINANCE iR Lt-2381
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 e'er for homestead feel.homestead fraud causes higher tax bills for all:therefore.
• HEA 13442000 requires uspa)es who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional identnying informauun nccesmn to allow county government to better monitor homestead
tiling,.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 mull that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Bethe, Herbert J Jr Etal
i 10N Main
I laubstadt IN 47639
8150
Herbert J Bethe Jr Etal Jr.
110 N Main
Haubstadt IN 47639-8177 State Parcel Number Legal Description
IIIIIIIIIIIIIIRtttllllllltlltlrtttlllttrlltltlttlllllrttltltll 26-19-31-301-000.022-009 013-00022-00 PT SW 31-3-101.49 AC
PART 2:TAXPAYER-INFORMATION
Owner I First Middle Last
' l
�1 Lire �7 v' ilf2 ."R. TAB
•Tg Address(number and stem,city.state,and ZIP code) _ - --- — Same as pmpefy oddrecs - - —
I/o 111- MPrflal
Spouse First Middle Last
Mailing Address(Number and street,city.state,and ZIP code) n Same as property address
Social Security Number(last 5 digits) Drivel's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Sr
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 I Signature (�,, Date
\ )
PART 4:ADDITIONAL INFORMATION
•