Homestead_Gieselman (2) • (IAIE FORM 53 W IRS,YMI ThFASL tOA FOAM IS-IA
AP•MT'ED BY MITE IYMRO Or Arl,PU Tc.'n`I PtI-`YAIBED BY Tar DEPARTHLYr(F LOCAL GOVOINMIWT FIANCE IC 4.1.1-2:4,1
Gibson County Auditor
J01 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to are homestead standanl 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 44-22009 requires taxpayers who receive the homestead standard deduction to eerily that they are eligible to receive the
benefit and to panicle additional identifying information necessary to allow county government to better monitor homestead
filing.This information will he kepi confidential and can only he acressed by authorized county officials.The Department of
Local Government Finance'ill use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
Gieselman, Harold E Jr
Box 259
Somerville IN 47683
8444
Harold E Gieselman
5092 S Lincoln State Parcel Number Legal Description
OAKLAND CITY IN 47660-7659
�I�II��ttl�t��ttl��IF��tF F�Ft F�F��FFF�F�F�F�F F�1�1I tI�I��F lu.I 26-20-02-402-000.111-003 020-00111-00 PT SE 2391.45 AC
X
Mailing Address(Number and street.city,state,and ZIP code) Same as property address
Social Security-Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sox
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
Spouse Signature Date Telephone r l
PART 4:ADDITIONAL INFORMATION
y A"n CLAIM FOR HOMESTEAD PROPERTY TAX FORM �YE�AR
CREDIT /STANDARD DEDUCTION
State Form 5473 (R5110-01)
Prescribed by the Department of Local Govemment Finance
INSTR)ICTIONS: See reverse side for riling instructions.
I (We) certify that on the 1 sl day of March, 20
I (We) occupied as our principal place o residence the f (lowing described real property for whi a Homestead ProIM&ax]C.Rdl2N2reby claimed:
❑ 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 t�ropeny- or-j�bul Jh undeyp /I wpyact.
�r_.-"' rF�•* '�2s'i=.a`tI'"`'-'f'- >`ss"')`ii CONTRACT- RECORDED•- ss''�i'sE",.YV'-'
If buying on contract, Fee Simple owner's narne
Recorders office where contract is recorded Record number Page
. <;. - �s''z�".'__-.�."'°•'�n5f.'%F3'
P, ROPERT, Yi DESCRIPTjON�f ''?.n- °%''_r-`r,4,'"'aw-
nty
Township
Taxing district (city, town, towns ip)
Paroe number
eg a cnptien /
P S 3-9 %
Is the property in question:
❑ Real property ❑ Mobile Home (LC. 61.1 -7)
if any portion of the residential structure or the land not exceeding one (1) aae that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
l�q % (pao -oo3as -oo>
Land not exceeding 1 (one) acre immediately
= 5.1"`�`""�° a? ROP. ERTY, OWNEDTBY� 'CLAIMANT,INOTHER'COUNTIES�.:,i
County
Township Township
County Township
I hereby certify the above statements are true, correct and complete.
Signs re of claimant
(number and street, c+0: state, ZIP code)
3 7o Da a c
�N Y 76
a „
A�SSESSOR�USE ONLY-
ITRUEaTAX
';,VALUE• �''
ASSESSED VALUE
sH MESTEAD,'rL`
_
.M".srE� M
y",yA,Ttt 00 %'OFTTVPwT}r
VALUE„y
Land not exceeding 1 (one) acre immediately
1
'
�•" L�:a
surrounding residential improvements.
5
Other land
(2)
,';
,''r-"
141.1
5011 101
Total land (line 1 plus line 2)
(3)
Dwelling
(4),`.1s'
.2a. =t ail• A.
es -
Residential improvements^"'*
_
Garage
s
(5)
•��r��'h`� - �,.a
Other improvements
Total improvements (line 4 through line 6)
(7)
Trial value (line 3 plus line n
(6)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20 _
Lesser of 1/2 Homestead
Valuation or $6,000
S
of Signal I i