Homestead_Reinbrecht a. STATE FORM'5Y IR:/F-Nt IRFtiUEER FORM.B-IA
.APPROVED BY CITE BOARD OF ACCOUNTS zow PREYAIBm BY Tilt DEPARTMENT OF LOCO.GONEEAYMET'r FINANCE IC 4-1.1-524.I
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.I tomestesl fraud causes higher lax bills for all:therefore.
HEA 1344-200C requires taxpasers who receive the homestead standard deduction to verify that they are elieiNe to reecho the
benefit and to provide additional identifvmt information rtecessan'to allow county government to better monitor homestead
filings.This information will he kepi confidential and can only he accessed by authorized county ofliciais.The Depanntenl of
Local Government Finance will use this information to create touts that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
—. Reinbrecht, David W/Debra K
306 W I laub ST
-
I laubstadt IN 47639
8202
David W/Debra K Reinbrecht
• 308 W Haub St State Parcel Number Legal Description
Haubstadt IN 47639
26-19-31-303-000.180-009 013-00180-00 ORIGINAL PLAN 166/167
•
P'
PART 2: TAXPAYER INFORMATION
Owner I First • Middle II ''� Last
�Av\o+ (�a l}°e r �-e i 1\ r eck
t.g Address(number and street,city,state,and ZIP code) — _--- — 0 Same as rty eddies:— - — —
3o W, HatLb S-I- t-k at,Aos-lad+ ,rN u -e39
Spouse First Middle Last
erA k0.` 1-ekA.bre
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
3o Wt \-k 0..0_1/40 S4- , N13.L.30S -- tAJ 4-2 t,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 lia le for back taxes and substantial financial penalties.
Ow= I Sign /ea Date
PART 4:ADDITIONALTNFORMATION
CLAIM FOR HOMESTEAD PROPERTY TAX t PpRM YEAR
CREDIT /STANDARD DEDUCTION HCto
.;, State Form 5473 (112 15-92)
ia
INSTRUCTIONS: See reverse side for filing instructions. g Iff
ale) Ot _ _ °S"' tCW th f %lne 18ddrC%arch, 19
�I- I(,We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit yis hereby claimed:
�yl 1 (We) owned I] Are buying under contract . - , _ . t �� ��/ff(11-1T ((����pATcrs
Have a beneficial interest in the entity, that is liable for the property taxes on the property and that owns the property�u3nUylf7g'tlnder a contract.
• - CONTRACT RECORDED
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
- PROPERTY DESCRIPTION
Court
Township
Taxing district (aty town, township)
Parcel number
Legal description
o 13 -ooIt co
l
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds tha structure is used to produce income. describe the use and portion
of the property utilized to produce income.
Sign ur of c mant
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
1
(1)
Valuation or $2,000
Wereby certify the above statements are true, correct and complete.
Sign ur of c mant
(2)
Addre number ands et, ary state. ZIP Code)
Po
-
ASSESSOR USE ONLY
- TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2,000
Signature
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 6)
(7)
Total value (line 3 plus line 7)
(S)
1 hereby certify the above is true, correct, and
mplete.
Signature of Assessor
Date signed
lying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
$
Valuation or $2,000
Signature
DaSgney