Homestead_Ungetheim .. VI ATL 1 ORM!YM IR-1 urn 1RFASURFA FORM 75-1A
APPROVED PY St AIL BOARD Of ACCOUNTS-!v,4 PRESCRIBED BY 11W DRART16470r LOCAL CNELNMEA.FINANCE MLI.1U'-.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homeucad srandarrd deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than eter for homestead fraud.Ilomestead fraud causes higher tat bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to receive the
benefit and to provide additional identifying information necessary to allow county goremment to better manna homestead
tiling. limit information will he kepi confidential and can only be accessed by authorized county officials-The Ikpannient 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
_ Ungetheim, Charles W/Sandra K
1003 Adam Court
Haubstadt IN 47639-8164
7273
Charles W/Sandra K Ungetheim
1003 Adam Court State Parcel Number Legal Description
--_- -HaubstadflN-47639-8164--- --- - ----- — — - - - - - ----
IIIIIIII III III1111IIrlr lrr lll'lII III II'lII IIIIII 111111D1
266--1188-36-401-000.617-009 013-00617-00 WEST HGTS 4TH ADD2
PART 2:TAXPAYER INFORMATION
Owner I First Middle Laze
(1la rI waif .. LD`iILaIAA-, / .Lfte-44
�g Address loom and sweet.city,state,and ZIP code) Somet5"4operty address • - -- - - —
1 003 AdaM- (../4---
-
Spouse First Middle Last
Mailing Address(Number and street,city,stale.and ZIP code) 1, $icI as ft.beny address
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
• •
d 4 CLAIM FOR HOMESTEAD PROPERTY TAX.FoRlvl
CREDIT /STANDARD DEDUCTION Hc10
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See. reverse side for filing instructions.
It-11,A I WIVE A I A I tMt:N I
YEAR
1q9
GtFt.l
I (We) rtify that on the 1 st day of March, 19
I (We) occupied as our principal place of residence tIQ foll9wing described real property for which a Homestead
Property Tax Credit is hereby - claimed: (,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 a contract.
CONTRACT RECORDED
If buying on contract. Fee Simple Owner's Name
Recorder's office where contract is recorded Record Number Page
PROPERTY DESCRIPTION
rcel Number r ( D� Leal Descnpii 14 101- / [
If any portion of the residential structure or the land not exc ding one (1) acre that immediately slur- rounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON- RESIDENTIAL
VALUE
Land not exceeding 1 (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 1/2 Homestead
Lesser of 112 Homestead
Valuation or $2,500
(3)
Valuation or $1.500
Valuation or $1,500
(4)
-
-
(5)
(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 1/2 Homestead
Lesser of 112 Homestead
Valuation or $2,500
Valuation or $2.000
Valuation or $1.500
Valuation or $1,500
lure of Auditor
"
Date Signed
14- a - a-