HomeMy WebLinkAboutHomestead_KurzendoerferCLAIM FOR HOMESTEAD PROPERTY TAX
% CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
rsTi
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10 9
FILED
�e) �x. J�iMl/IC(. certify t on the 1 da {�o�lI MM ✓rarrc�chh, 19-W
e) occupied as our principal place of res. ence the fdnowing described real property for which a Homesti ' 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 the property or is buying under a contract.
CONTRACT RECORDED
It buying on contract. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County
Towns hi
Coun
NON- RESIDENTIAL
- VALUE
Taxing d tr I (city, tow , towns
Parcel number
3-
Legal descripti n
3
If any portion of the reside tial structure or the land not exceeding one (1) acre that 41mediatkty surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
Coun
NON- RESIDENTIAL
- VALUE
�reby certify the above statements are true, correct and complete.
Si nature o daimon
Address (number and street, dry, state, ZIP code)
— ✓ 6 —o /S
ii
ASSESSOR USE ONLY
TRUE TAX
.VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
- VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line b)
(7)
Total value (line 3 plis line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
yiN action - Signature of Auditor
Date signed
DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead $
Valuation or $2,000
Sl VE FORK∎!Nt m'I.W1 1PIA51:ILR EOM&YIA
.ArIWWEO DT ST 1lt WARD OF ACCOUNTS.lino PPLWBIDBY mE oEMME-W(f UEAt WVEtNMff EPANCE IC 11-1.14:4
.GibsonCounty 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 OCT for homestead fraud.I homestead fraud causes higher ta\bills for all therefore.
• HE.\ 1374-2009 requires taxpayers who receive the homestead standard deduction to verify that they are divide to receive a the
benefit and to provide additional identifyim_ infomanon necessary to allow county government to better monitor homestead
tiling..this information will he kepi confidential and can only be accessed by authorized corny 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 LNFORMATION
Taxpayer Name Property Address
_ Kurzendoerfer, Daniel R/Barbara may/
311 W Vine S'1' r 1,
° Ilaubstadt IN 47639
8174
Daniel R/Barbara Kurzendoerfer
311 W Vine St State Parcel Number Legal Description
Haubstadt IN 47639
26-19-31-301-000.409-009 013-00409-00 ORIGINAL PLAN
_ 138/139/140
I
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
D A-,4i l£[- RA/ KtiR2c-PiD6ER F
•t e.Address(number and street,city,state,and ZIP code) - - fl Same as*perry address - — —
Pc Box /S-% I74u857-4DT iA) e/7c 3 n1
Spouse First Middle Last
aae.BA T&i-A/ KURZ6d-bOERF'&2
Mailing Address(Number and street city,state,and ZIP code) ❑ Same as property address
Pe Bay /5Z7 /-/yaar i•✓ V 7434/
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 li.ble for back taxes and substantial financial penalties.
Ow Signatu Date
PART 4:ADDITIONAL INFORMATION
All