Homestead_Schultheis STATE FORM 53549(R3/8-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT RNANtE 1061.1-2222-8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS -
.. 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 ever for homestead fraud. Homestead fraud
uses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
Si dard deduction to verify that they are eligible to receive the benefit and to provide additional identifying
information necessary to allow county government to better monitor homestead filings. This information
will be kept confidential and can only be accessed by authorized county officials. The Department of Local
Government Finance will use this information to create tools that will help county officials eliminate
homestead fraud.
PARTI: 'PROPERTY•INFORMA ION
•
Taxpayer Name Property Address State Parcel Number Leeal Description:
Kenneth D Schultheis 214$FOURTH AVE 26-19-31-304-000.371-009 F PARK ADD 466/467
HAUBSTADT IN 47639
Complete and return to: l® 1[111 IKIIIOQlM®lII111IU([OMmlmm II 11 gp
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2: TAXPAYER INFORNNI.4T1ON
Owner I First Middle Last
Mating Address(number and street.ply,state and ZIP code ` �
ig Same as property address
z_ l L1 5 tf�--t , u e , . . .
�; - _ .
� First -_ _Middle - .... -__— Last
Mating Address(number and street city,state and ZIP code) Same as property address
Social Security Nunter(last 5 digits) - . Driver's License/State ID Number(last 5 digits) sacs Other(please specify in Part a below)
- - 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.
Omer 1 Signature Date
• ( )
PART 4:ADDITIONAL INFORMATION .
•
. - i : ----- . . — .
• r
n.
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (116 /4-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing insiruclions.
I (We) �y/Y�ir�D V f\ �C1C,/l ll YT I� 013
I (We) occupied as our principal place of residence the following described real property for which
❑ I (We) owned ❑ Are buying under contract GIBSC
Have a beneficial interest in the entity that is liable for the property taxes on the property and I
FORM YEAR
HC10
RP0I
t)iat �n/ hel�st day of March, 20_
Pip tax Credit is hereby claimed:
under a contract.
s I •cc -.i
b�3 �CONTRACT'RECORDED; ..Xa "Fs„�:'i,�
If buying on contract. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
`-�� x.�- �'� -`l" -• 2�- ss�,.'`,��i�F %3 s``�a� —°_ �' �. �v-=. P, ROPERT. YaDESCRIPTION�fit> t�h- t'a;�:�,��'`�=a.s*'"�- TC,,,• ?�'�-"�_.�+tdi
County
Tovnship
Taxing district (city, town, township)
P I number
L e cripti
Is the property in quesbon:
ddress (number and street, city, state, ZIP code)
%
❑ Real property ❑ Mobile Home (I.C. 61.1 -7)
If any portion of the residential structure or the land not exceeding one (1) aloe that im
of the property utilized to produce income.
iatety wnounds That structure is used to produce income, describe the use and portion
:. �: Lr' att�'`. ��` ���X 's.,-'��`'•k- �s- _�.�PROP,ERTY OWNED`BY;CL'AIMANT,IN! OTHER` COUNTIES:_`' r6.,, s.r {��`5?��i%a- 5:`�F�..I-��!��fi
County
Township
County Township
hereby certify the above statements are true, correct and complete. I
Signature claimant
ddress (number and street, city, state, ZIP code)
2 t (1 5, u
- ASSESSOkUSE ONLY4�y "
1zA +TRUE TAXI-+T -*�r
wVALUEY
ASSESSED VALUE
SAT 100 %'O FTTVA
i,.,�THOMESTEADrs
zWVALI
•yNON44. ENTIAL '' •S
�!' r,- .VALUE. -
Y4 z
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
2
()
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually^'
Assessed Mobile I Manufactured Home
Garage
_=
Other improvements
6
I SQL 4 ttY�J ri
Total improvements (line 4 through line 6)
(T )
Total value (line 3 plus line 7)
(6)
hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
,�t"afi;y f6} - STANDARD.'DEDUCTIONIALCOWANCE
20 _ Pay 20 _
Lesser of 1/2 Homestead $
Valuation or 535.000
Signature of Auditor Date ed
a -o