Homestead_Pfeiffer STATE I ORM!)W IR_r u't TREASURER FORM ia-IA
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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 ever for homestead fraud.homestead fraud causes higher in bills for all:therefore.
an. HEA 1344-3019 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
tiling.' Mix information will he kepi confidential and can only he aeressed by authori,cd enmity officials.The Ikpannlent 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
Pfeiffer, Edwin P/ Bernadette M
103 S Jeremy
Ilaubsmdt IN 47639
7368 -' -- ' — - - - -- - - - -- —— -- - -- — - - - -- ---- -
Edwin P/Bernadette M Pfeiffer
103 S Jeremy State Parcel Number Legal Description
Haubstadt IN 47639-8160
��t�r�rr�tr�rrrr��t��rr��tt t�1 ��Ftr��t� 26-18-36-403-000.570-009 013-00570-00 WEST HGTS 3RD ADD 303
It1tt 11t tr1E11rrtr
4.
' PART 2:TAXPAYER INFORMATION
Owner I First (n� Middle r Last
Ed w Y t t7 a.u Pie i ere Ir
�g Address(number and street,city,state,and ZIP code) Same as property address --- - —
/03 S • --.5 e e e_yyLi Ln . Haa6S+cidf In 417 (0 39
Spouse First Middle Last
ge r n a_d e-+-I- e rn CIL-V` Y-c e- rr 'c--c- e,
Mailing Address(Number and street,city,state,and ZIP code) ® Same as progeny address
103 S : SCr ent``jj LJt . la-a °os+ex...d.t 71 . (747 le-39
_ -
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
. .
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Forth 5473 (RS 14-03)
Prearn'bed by the Depmtrrrom of Local Government Fawnce
INSTRUCTIONS: See rewerso side for Ming inmucdom
F YE R
U -
I (We) e heQ�s�fl1�f March, 20_ oZ4 I (We) occupied as our principal place of residence the following described real property for whi ome a �gtst'T�� edit Is hereby claimed:
❑ 1 (We) owned ❑ Are buying under contract GIBSO
® 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.
...:in: —• - xvwsat4,s� ONTRACTiAECORDEDT
- �, e`�.f- l�- {r�o�''x- .�..`rr�#a'•e 3i`�•:rkaA��°�.�s,'�t
If buying on contract. Fee Simple owner's name
Recorders office where contract is recorded Record number Page
ROP.ERTYb%NEE`BYCLAIMAAHt.i 06TH ER' COUNTIES, 3- ,:99�'�`rT_-
County Township
County
Township
Sign ure of cla' ant
Taxing distri (Ciyown, township)
Parcel number
G 3 - oQ
Legal description
VALUES"
Is the property in question:
Real property ❑ Mobile Home (I.C. 61.1 -7)
If any portion of the residential structure or the land not exceeding on
of the property utilized to produce income.
)aae that immediately wrtounds That structure la used to produce income, describe the use and portion
ROP.ERTYb%NEE`BYCLAIMAAHt.i 06TH ER' COUNTIES, 3- ,:99�'�`rT_-
County Township
County Township
I hereby certify the above statements are true, correct and complete.
Sign ure of cla' ant
®" ddress (number and street, city, state, ZIP code)
ONLY
iRUETAX�j,
ASSESSED VALUE
HOMESTENNON�tESfDENTL4L
} }Y4g'ASSES0R-IUSE ^� $ ^'
- w„VALUE -
?`AT 100 °6'OFTTV
VALUES"
=3 VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Otherland
(2)
SM12
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
'.'r
fr£
'Residential Improvements or Annually
#�.,'�,,S�.a
Assessed Mobile / Manufactured Ht1me
Garage
(5)
`+ r ,
Other improvements
(6)
-- :, s
..,-U.�,,�F-�.•-
' �t�'._
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(a)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
•._` .'_�' --,a' '.' •`_,� $ '•-"?= "o- ;b ?�' �' ' TANOARMDEDUCTION 'ALLOWANCE.= :�" >":, - E- ''§-'3r�s'",,s ,•- ' `.
VW - rcP�,N"� .: rte` <-.. :mss*:. �. " 1�°• �.d
20_Pay 20_
Lesser of 112 Homestead
vauanal a f35.000
Signature of Auddor - Date signed