Homestead_Rexing (5) o
VIAiE I ORM!IW IR'r.+wl TREASUAEA FORM ISIA
APPROVED BY',PSI MV O Of AM1YtL5TS.tI+ rrf.YRmw BY 1111.DFPARMLYT OF LIX:LL CAHrR.YMENT Fn:A\CE IC 4-1.1-12-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 gandard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher at bills for all;therefore.
® m
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to reeeise the
, benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
flings this information will he kept confidential and can only be accessed by authorized county tannins_The Depanmem of
Local Government Finance Mill use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
' Taxpayer Name Property Address
Rexing, Tammy
116 S Weber DR
Haubstadt IN 47639-8130
7405
Tammy Rexing
116 S Weber Dr State Parcel Number Legal Description
Haubstadl IN 47639-8130
I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1 1 I I I I I I I I I I I I I I I I I I 26-18-36-404-000.282-009 013-00282-00 PT SE 36 3 11 LOT 116
Owner I ...." First Middle Last
-.11am(AtG� —��'�n Q'x'n �(b
•tg Address(number and street.city,state,and ZIP code) -- -- mne as Property eddies-- /l --- -
Spouse First - Middle Lug
Mailing Address(Number and street,city,stale,and'LIP code) ❑ 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)
Slue
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 S sum Date
)
PART 4: ADDITIONAL INFORMATION
•
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (RO / 4.03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
CERWICATION STA ENTO>
•'
I (We) c that 1st �h,
I (We) occupied as our principal of reside ce the 1 Homes --14 .!� �y�ofM�ioirl
ng described real for t
property which a claimed:
.yya
.Jpdi��Lt,v.*b
X-1 (We) owned ❑ Are uying under contra
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.
, townstilp)
?.,V-7af�--���'IW,�0-4iMCONTRACTLRECORDED
If buying on contract. Fee SnrpIo owners name
R000rder's office where contract is recorded
Record number
Peg
02W M
",W� -W" 'OWNE[i-
Mg 4 Z—%VNM� PR16P.EkTVII 1111Y,
County
TaImstup
T
(city, to
, townstilp)
Vauation or 535.000
I/j
1g
zz
I
Parcel nu r
Legal description
Is the pil
Title] land (line I plus line 2)
(3)
.Auestion:
Real property ❑ Mobile Homo (I.C. 0-1.1 -7)
X
ff any portion of the residential stru cturs or the land not exceeding one (1) acre that immediately surrounds that sVidure
of the property utilized to produce income.
is used to produce income, describe the use and portion
02W M
",W� -W" 'OWNE[i-
Mg 4 Z—%VNM� PR16P.EkTVII 1111Y,
County I Township
County Tmnshii
I hereby certify the above statements are true, correct and complete.
Signal claimant
raw )(n%ber and street, city, atale, ZIP code)
:5.
VW
SaFAAMMMUSE0,14
R U ZTAX,.-K-fif
0
'ASSIESSEDMALUE
'HOMESTEAD'
MA KWIM
ON-RESMENTIAL
N -,"rA
Y;�: VAL EjiR
I
Land not exceeding I (one) acre immediately
surrounding residential improvements.
Vauation or 535.000
Signature of Auditor
Other land
(2)
1-N 1IEE1R1E .I,
W1NA '
Title] land (line I plus line 2)
(3)
Residential Improvements or Annuafty
Allseaved Mobile I Manufactured Home
Dwelling
Garage
(4)
(5)
a
L 7
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
I
Verifying action - Signature of Auditor
Date signed
DARWMEDUCTION"ALLOWANCE'
20 _ Pay 20 —Ts
Lesser of 1r2 Homestead
Vauation or 535.000
Signature of Auditor
Date signed
FAF