Homestead_Schmitt (8) t 1A1E FORM!)!MIL I WI TYIA5tnnx FORM ZIA
*MIMEO BY STATE IXHRO OF NYYR■S'Tt 2U ettt'T➢FDaY TIDE DEPARTMEIT OF HEAL GOVERNMENT FINANCE te4-1.1 r-F.1
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 eser for horestead fraud.Homestead fraud causes higher tae bills for all:therefore.
. HEA 1344--2009 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to recene the
benefit and to provide additional identifying information necessary to allow count'government to better monitor homestead
filings_ this information will he kept confidential and can only be accessed by authorized county officials_The Dmtnment of
Local Government finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Schmitt, Kenneth R/Roberta G
RI Box 562
Haubstadt IN 47639
8131
Kenneth R Schmitt
406 E Church State Parcel Number Legal Description
HAUBSTADT IN 47639-8211
Itlttllttt lrl lttt tllt'tlt tltr It tt'lltttlltttl 111 let llllt It lltl 26-19-31-101-000.658-009 013-00658-00 ELPERS-NEUMANN 11
PART 2:TAXPAYER INFORMATION
Owner I „ ` First Middle ,1 ,, Last
ietAP
g Address(number and Street,city. tate,and ZIP code) - — — Snme as property rvsody diess(�l/' - —--
LIO G e . /9. 1a��, �,,. 11-7639
Spouse A First Middle n • as Last
Mailing Address(Number and street.city.state,and ZIP code) � 4me as property
Div 1 , fl fat � , L .
L�7639
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 eliuible 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 Signature Date
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (RS / 10-01)
Prescribed by the Department of Local Government Finance
FORM � YEAR
11- _LL J +.wd � i...�
I (we) 241 frr� �0' _fy'lina-t on th-4-1s-t day of Mitch. 20
/ W1 '/ 11
I (We) occupied as our principal place of residence the following described real property for which a Homestead Property:Jix Credit is.hereby claimed,
❑ 1 (We) owned ❑ Are buying under contract Ij C,
Wave 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.
T!
ONTRAC RECORDED-
If buying on contract. Fee Simple owner's name
Rewrdees office where contract is recorded Record number Page
4
Millill
-, , '.
1'1-ZMz . , 4. A
'f
g .:ASSESSORUSE ONLY
�2 FEZ7, R 0 0 E 0 TY, 6 E S C R [0 T i b N �n
County
Township
Taxing district (city, to", township)
P I number
3 X&S9-0)
Legal qscription
k1tjj3-;- /Llzfn�
P
Is the proipertyui3p�tflon:
t.^eal property ❑ Mobile Homo (LC. 61.1 -7)
If any portion of the residential structure or the land n-4 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.
Other land
0kdip-EkTKbWNEb-BY CL"'klM-A-kt;ik-OTHER'CdUNtitg�&-
County Township
I
—J-
County Township
i
I hereby certify the above statements are true, correct and complete.
Mclaimant
92
+
+ddress (number aM street citypp; state, ZIP ode)
4
Millill
-, , '.
1'1-ZMz . , 4. A
'f
g .:ASSESSORUSE ONLY
�17"-
'Z�`TRUE'TAX e��
M.VADE �7Z
ASSESSED VALUE
ATAQQ% -OF
;,.',HOMESTEAO-��
11JEC
&X*WVAL
11,W
N
ESIDENTIALZ'�';T
U
Land not exceeding I (one) acre immediately
surrounding residential improvements-
$
Other land
(2)
Signature of Auditor L )
Total land (line I plus line 2)
(3)
ate signed
Residential improvements
Dwelling
(4)
-re
A&Z
,
WM501
Garage
(5)
Other improvements
(6)
Total improvements (fine 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.
Verifying action - Signature of Auditor
Date signed
-,E TANDARD.DEDUCTIONALLOWANCE
it.:;--.91,J-t"-'ik,,
20_ Pay 2O_
Lesser of 112 Homestead
$
Valuation or $6,000
Signature of Auditor L )
ate signed