Homestead_Riffert SIAIE!FIRM 53 V+IR=1•-wl 1FLAStJLER FORM TS-IA
VPpw'EII BI MATE WARD OF Aft.NI,."no PRIWRIBED BY flit DEPMMr.Ya(w LOCAL c vrryMrN'r FINANCE MVI.I-r4I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD. PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standand deduction. As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taapaycrs who receive the homestead standard deduction to verify that they am eligible to receive the
benefit and to provide additional identifvina information necessary to allow county government to better monitor homestead
tiling_,.This information will he kepi conlidemial and can only he accessed by authorized county official..The Department of
Local Goverment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ __. _ - - - --- - 'Riffert. Jay -
305 S 2nd AVE
Ilaubstadt IN 47639
8268
Jay Riffert
305 S 2nd Ay PO Box 272 State Parcel Number Leal Description
Haubstadt IN 47639-0272
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1)C
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
- �ng Add (number mid snot.city,state,and ZIP code) — — Same ns property address —— - -
I Oa _yr
e.
Spouse First Middle Last
Mailing Address(Number and steel,city,state,and ZIP 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)
sys
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 elieible 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_enature Date
PART 4:ADDITIONAL INFORMATION
•
•
A
aj;n�4 CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10 0
State Form 5473 (R2/1 -90)
° INSTRUCTIONS: See reverse side for filing instructions. /
CERTIFICATION STATEMENT
On
a) _ certify that on the 1 st day of March , 19
Occi.4ed 4ur princip p ce of residence the following described real property for which a Homestead
arty Tax Credit is hereby 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.it under contract.
- a5-13- 4i' rr'i ri "rl
CONTRACT RECORDED
If buying on contract. Fee Simple Owner's Name
JUN 1
Recorder's office where contract is recorded /Record Number Page
AUDITOR
rnvr �n r r ✓�.avnrr r w�•
County /T -
town,
P r ffum er Legal Desc n � 6
i � {
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
County
certify the
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
are true, correct and
/Address (Street. num^ber, city, qstate and ZIP code) 1 t #1 V ,�
'�i179 Qer/ 4II° _ Rr. r 4- ?—Q f C? hr 16 ,it. 7639
ASSESSOR USE ONLY
TRUE TAX VALUE . ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding t (one) acre immediately
surrounding residential improvements
Other land
Total land - line (1) plus line (2)
Residential improvements Dwelling .
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
(1)
1991 Pay 1992
19— Pay 19—
Lesser of 1/2 Homestead
(2)
Lesser of 112 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
(3)
Valuation or $1,500
Valuation or $1,500
(4)
Signatur of uditor
(5)
ate Stoned
3_
(6)
(7)
(8)
1 hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990
1990 Pay 1991
1991 Pay 1992
19— Pay 19—
Lesser of 1/2 Homestead
Lesser of 112 Homestead
Lesser of 112 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
Valuation or $2,000
Valuation or $1,500
Valuation or $1,500
Signatur of uditor
ate Stoned
3_
V