Homestead_Heichelbechd. F.A•,4 CLAIM FOR HOMESTEAD PROPERTY TAX Fog YEAR
3 ` y CREDIT /STANDARD DEDUCTION r ?5 "H�
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side torJiling.instructions.
CERTIFICATION STATEMENT [t �.Y 10 1991
I (We) A J . �L V `�,t.C�nSXJ�1 certify that onn�Y ,&,D',PP 419 q I
'I (We) occupied as our principal place of residence the
, following described real propMo��ich a Homestead
Property Tax Credit is hereby claimed: 1l� I tvve) 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 or is buying it under a contract.
CONTRACT RECORDED
If buying on contract. Fee Simple Owner's Name
Recorder's office where contract is recorded Record Number Page
rKUIIL i I T Ut.7V 1-111'
L AJ_ Taxing
Legal
township)
J -
If any portion of the residential structure or the land not exce ing one (1) acre that immedi tely surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Otherland
Total land - line (1) plus line (2)
Residential improvements Dwelling
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
(1)
-
19 — Pay 19—
Lesser of 112 Homestead
(2)
Lesser of 1/2 Homestead
Lesser of 112 Homestead
Valuation or $2,500
(3)
Valuation or $1,500
Valuation or $1,500
(4) -
-
-
-
(5)
(6)
(7)
(8)
1 hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990
1990 Pay 1991
1991 Pay 1992
19 — Pay 19—
Lesser of 112 Homestead
Lesser of 1/2 Homestead
Lesser of 1/2 Homestead
Lesser of 112 Homestead
Valuation or $2,500
Valuation or $2,000
Valuation or $1,500
Valuation or $1,500
Signature of Auditor
Date Signed
A
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StMtt 1010153M ULt S-wI MEASURER FORM:}IA
.APPROVED BY SIAM cot. unr Mc*LsTS.]Vw PIII211,JBED BY air DFPMt56Yr OF LOCAL COVERNMINT FIANCE 1C i.1-_11
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 net for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• NEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reecho the
benefit and to provide additional identifying information nec ssan.to allow county government to better monitor homestead
filinf,..This information will be kept confidential and can only to accessed by authorized courtly 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
Taxpayer Name Property Address
Heichelbech, Thomas L/ Patricia
107 S Weber Dr
_ _ _ . - - ____ _ _ -_ - _. _ - _•_ Haubstadt IN 47639-5130
7381
Thomas L/Patricia Heichelbech
107 S Weber Dr State Parcel Number Legal Description
Haubstadt IN 47639-8130
1r1rr11rt r�t11trr r11t1r1r r1rr1rttt�lrtlitllttt�ltrtltt rlt tlti� 26-18-36-404-000.018-009 013-00018-00 WEST HGTS 2ND ADD 107
PART 2: TAXPAYER INFORMATION
Owner I First Middle I Last
I n CtClI e Mee
g Address(number and street,city,state,and ZIP code) - - - -- - ---- g Same as popery address -- --- — —-- -
Spouse First Middle _/ Last
Pca.tr:c;a t<1/ tin / e ' A€ )steer
Mailing Address(Number and street,city,state.and ZIP code) / ®Same as property address/ / /
• uII�/
ors
Social Security Number(last 5 digits) Driver's License/State ID Number (lust 5 digits) Or in(please specify in Part 4 r low)
y -o %36I
s-. 6 9 y3 ti
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury.that the above and foregoin 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 are Date
PART 4:ADDITIONAL INFORMATION
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