Homestead_Rexing (4) 31.-.: -•-• -
STATE FORM 535t0(U I&10) 'MEASURER FORM TS-IA
APPROVED By STATE BO.Rn OF ACCOUNTS,2ID9 PRESCRIBED BY THE OEPARTME\T OF LOCLLGMTANMCVr FINANCE IC 411-222.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher ax bills for all;therefore.
• F T�E D HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
IeI
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county 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
MAY 5 2011
Taxpayer Name Location Address
C' 'rc 1 Rexing, Ray J
• , GIBSON COUNTY AUDITOR 428 BRADLEY DR
HAUBSTADT IN 47639
1622
. - -- _~- - 7 --- ii illll11 lMMIMMMI IIIII:If�IIIII[I III ll iillif_ICliilli III IMMIl iii II llilld - -=
Ray J Rexing
428 Bradley DR
HAUBSTADT IN 47639-8157
'lll'lllllllllll3ll11 III' tttrllllll'll'llllill'lll"I"1'11'111 State Parcel Number Legal Description
26-23-06-101-000.670-009 SUNRISE ACRES 16/17 D-9
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
__r _•
Ow-.n;1 . p �j First Middle �{ Last
Ray Jr /lexis40) Rd/ T`� `� fjex ' '7 ,i
Mailing Address(number and streEC city.state,and ZIP code) Blame as property address
. / S &ai/e y A. , c J sT JT .T V H?t5.� 9
Spouse First Middle Last
teedile=)/
Mailing Address(Number and street,city,state,and ZIP code) fl Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
l l l l i i I l I
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 1 Signature Date
( )
PART 4: ADDITIONAL INFORMATION
CLAIM FOR HOMESTEAD PROPERTY TAX FORM V YEAR
CREDIT /STANDARD DEDUCTION Hcfo
State Form 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse &tb forts slabucdory,
I (We)� cerfify that on the 1st day of March, 20
I (W upied o p cipal place of residence the following described real ope for Homestead Property T� i�lgs hereby ed:
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 buyinggiunder a ...
If buying on contract, Fee Simple owner's name
Recorder's office where contract
Remrd number
3�z, .'n3..'��- �i'•s'��iY�.- �'...�•z -rte a4cEPROP.ERTX�OWNED'BY CLAIMANT;IN OTHER' COUNTIESN�. �; �' �= �i' �' T3S�� 's•.x`- "��`- dl3t"'wv- .•�''".S
Pr-A
—P 01R01PERTY:DESCRIP,TION �`.�_ ¢" �� *��v'�?i� a i-
=
Sign a claim
,;�' -`2p�' t'� -'�,a ,,,�sy � �•
-
County
County
Township
��r 'ASSESSOR USE ON Y 5+.
Taking dirt' , t s p
a
Legal d
'ption c the property in quesfio -
r ..L .�-..-
praperty ❑ Mobile Home (LC. 6-1. 1-7)
If any portion of the residential struqume w th of exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
Land not exceeding 1 (one) acre immediately
3�z, .'n3..'��- �i'•s'��iY�.- �'...�•z -rte a4cEPROP.ERTX�OWNED'BY CLAIMANT;IN OTHER' COUNTIESN�. �; �' �= �i' �' T3S�� 's•.x`- "��`- dl3t"'wv- .•�''".S
County Township
County Township
hereby certify the above statements are true, correct and complete.
Sign a claim
"ddress (number and straej city, state, ZIP code)
Y
��r 'ASSESSOR USE ON Y 5+.
f '[j
i TRUEvTAX r
�YAI:UE. �"
- .'.V^+
ASSESSED VALUE
�r
7HOMESTFIID s'
t.csn _ _
„- NONW - ilDEN�TIAL s
��s`�'
r ..L .�-..-
AT 100 %.OFTTV
r.v.,.. VA
,s VALUES
4W ,
3' VALUE
_r Barr- L.a.... -, �.,w..�T'`a x?�
Land not exceeding 1 (one) acre immediately
JX �' YrKlt:.,Y.AVTn.,.
surrounding residential improvements.
(1)
.�
Other land
g M��a
(21
�'r:
Total land (line 1 plus line 2)
(3)
'Residential
Dwelling
(4)
�f,^a 1..
SERVE; �"� 20 c
Improvements or Anniltdly
Assessed Abhile I Manufactured Home
Garage
5
Other improvements
(6)
W
> i
Total improvements (line 4 through line 6)
(7)
Trial value (line 3 plus line 7)
(S)
hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Van" action - Signature of Auditor
Date signed
of Pudic«
20_Pay 20_
Lesser of tr2 Homestead
valuation or 535.000