Homestead_KammererCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HCIo
State Form 5473 (R2 / 5 -92)
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INSTRUCTIONS: See reverse side for tiling instructions. v
- reonnrnnnu erereucur r v w �nnr
L(We) II A 1(1 A_.EC -A--L r \W(►V1T I 0 All t, certify file ) on the 1 st1dyay o .March, 19
IIe)- occupied as our principal place of residence the following described real property for which a Homestead P7€r111'�1COkd ' i .claimed:
1 (We) owned ❑ . Are buying under contract AU DI
❑ 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.
- -
CONTRACT RECORDED
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
- PROPERTY DESCRIPTION -
County Township
Taxingct (city, town, township .
County
-oa
I
It
ParceLm6r Legal description
Date signed
_
Other land
It any portion of the residential structure or the land not exceeding one (1) a that immediately surrounds that structure is used to practice income, idescribe the use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
eby certify the above statements are true, correct and complete.
Sig ture laim t
Address (number and street, city, state, ZIP code) �Op L V61,3
ASSESSOR USE ONLY
TRUE TAX
VALUE =
ASSESSED
VALUE,
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
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 pUs line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor -
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or 52,000
S
Signature of Auditor
Date signed
MATE FOAM!Mt.IR-/vu&, tR(ASntfA/ORM 73-In
•
AerMr:m BYAUERMRnM MYYRPT%.9N ELrffi1Imwp BY THE BEPARTMMTCw LOCAL r{NTRVMrnrB:AGcEa'H.I.r4.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 aer for homestead fraud.homestead fraud causes higher tat bills for all:therefore.
®
HEA 1344-2006 requires axpayera who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying infommmun necessary to allow county government to better monitor homestead
filing..This information will he kept confidential and can only he aece vd by authorized county officials.The De anmelt of
Local Government Finance bill use this information to create Oohs that will help county officials eliminate homestead Gaud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Kammerer, Mark G/Nicol
ealdredge-- �''vo Wa.L:a. .
Kt1•.M+*,r P O Hon 306
Somerville IN 47683
8458 •
Mark G Kammerer
PO Sox 306 State Parcel Number Legal Description
SOMERVILLE IN 47683-0306
ItIIIII.III,lliili.liiiIIIII liiiliIIIIIrIIIIIttlItilttill 26-20-02-403-000.080-003 020-00080-00 HIGHLAND PLACE 29/30
PART 2:TAXPAYER INFORMATION
Owner I First /� Midd)< Last
_ 1'� ark C VQv .. rLv-
illng Address(number and sweet,city,state,and ZIP code) - - — / O Same as property address- — - -- - -—--
PO SOX 306 S®mltvUl I I -t , I ki (47CDS-3
44dc2r
Spouse First Middle Last
NI 1 col-t_ . KQ rn. rho t rR._ r
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
PO 3C7,4 30(x, Son,-, ,r-r ✓i I I-Z , /NI LI7G, Er_3
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
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