Homestead_Rohr NWT.1.110.4'3!M11r2/•+••1 TPFASIAIII FORM:S-IA
nrrNF�EO BY ST.i in WARD Cif Nnouvrv.fim RFSFIDm BY ME DFYMTNEVTOF LOCAL OO ERVMFNT Fa:AYt K -I.1-i•4.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 e'er for homestead fraud.Ilomessead fraud causes higher tae bills for all;therefore.
• HEA 134?--3009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings,T1tis information will he Lepi confidential and can only he accessed by authorized county officials.The Dcpanment of
Local Government finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Rohr, Terry J/Phyllis A
IOl l W Gibson
llaubstadt IN 47639-8169
•
7286
Terry J/Phyllis A Rohr
1011 W Gibson State Parcel Number Leal Description
Haubstadt IN 47639-8169
��t�t�tt�tt�t toll llltt�t�rtr tt��t tt��t�s�t� 26-18-36-401-000.657-009 013-00657-00 WEST HGTS 4TH ADD 10
I t1r(11r tt1r11ttrt
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
7 a/fx
-_-
ling Address(number and street,city,state,and ZIP code) -- ' - _ Same as ptuperty address' - - -
/0 // W, g/) $ 4) 577 ,79 Bciri2i�� /4/ �Y 713 e
Spouse First • Middle ��� Last
f2/974 C75 r R
Mailing Address(Number and street,city,stale,and ZIP code) 11-.trSume as property address
W 6 /Bsati s r . fdf�1U8s7 t'b0i
—
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
as °4 CLAIM FOR HOMESTEAD PROPERTY TAX
i' CREDIT /STANDARD DEDUCTION
State Form 5473 (R215 -92)
yu
INSTRUCTIONS: See reverse side for filing instructions.
FORM AR
HC10
"'We) 1 / - �/�Cl V�[ii'�i certify that on the 1st day of March, 19
�e) occupied as o r p incipal place of resid ce the following described real property for which a Homestead Prop it islyldieLa;med:
�We) owned ❑ Are buying under contract I �Ipp1144JJ���D
❑ 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.
IQVD 7 • 100A
CONTRACT RECORDED -
It buying on contract. Fee Simple owner's name - S
AUDITOR
Recorder's office where contract is recorded Record number Page
- PROPERTY DESCRIPTION
County Township
Taxing district (city. to nsh 1 _
- ^el n r Legal description
- 00 6s� 0� l�J I&I
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surround at structure is used to produce income, describe the use and portion
of the property utilized to produce income. -
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County T County To
�reby certify the above statements are true, correct and complete.
Signature of claimant
oicress (number and street. city, state. ZIP code)
`�
F
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 52.000
Signature of Auditor Date signed
Other land
(2)
Total land (line I 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)
(g)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
itying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
S
Valuation or 52.000
Signature of Auditor Date signed
I