Homestead_ViekeI� .- .. \
�� . STATE FORM 53514(*318-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.L.OI TRESCRIBFD BY THE DEPARTMENT OF LOCAL DOVER%ME'n FINAL IC 6-1.1-224.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to ane homestead standard deduction.As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead.fraud.Homestead fraud causes higher tax bills for all;therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard 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.Thc Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
OCT 31 2012 PART 1: PROPERTY INFORMATION . • • •
Taxpayer Name Location Address
C. .� Vieke, Thomas J/Donna R Peterson
GIBSON COUNTY AUDITOR 409 E Church ST
Haubstadt IN 47639
2684
Thomas J Vieke II BIII_�III III I IIII _I �I VIII �I�III HI DII�II�IIQIII�IQII_ III I �II�II_II I I�IIII
409 Church St
HAUBSTADT IN 47639-8211
11111'111111'11111111111111111 III"'111'1111"11'I"'111'11111111 State Parcel Number Legal Description
26-19-31-101-000.005-009 ELDERS NEUMAN 8
This form MUST be returned to County Auditor's office. .
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORDMATION . ... .
O' t ' First Middle Last
1140441Q.
1zW O 711Um4S J-0/JAI VIEKE .
Mailing Address(number and strut,city,state,and ZIP code) Same as property address
YaQ EA-sr et)ttReg S7UEr W4at$rAnr IN q��3q, .
• Spouse First esu� Middle �I��C • � Last
LIONNR K —/ l
j Mailing AddrL55(t.t mbci and street,nty:state,and"LIP-code) -. . - _. _I $ame aspmperty address'
coq Ens- d- c e# SLEET- /IfluALsTer, /n/LLL1011 yglD sq .
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 ck tax an bstantial financial penalties.
Owner 1 Signattm�/� ` _ Date
° a - PART 4: ADDITIONAL INFORMATION . -
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION
Stete Form 5473 (R614 -03) 1
Resented by the Department Of Local Govermnard Fmnos
INSTRUCTIONS: See revers &W Rr 1111na iw6udiwa
,(we) AL I O XA-a- / �� .X/[JJ V �. �Ll /l-� � ll C!/ ?—r'AL /certify that on t # y of f", 20_
1 (We) occupied as our principal place of residence the following described real property for which a Homestead Property Tic } OgA��
lqed:
El I (We) owned ❑ Are buying under contract GIBSON
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.
NTRACT;RECORDE_D_s�
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
a"`�>- �s°:ia�"�_ ��€�si'.�.��' .'�'Yti�s "�'�,S �P.ROPERT,Y DESCRIPTION 'k`_- =�."�'v��- �`<���„� ;�;�:g^��s•.xA �?s+;°�'4 >�
,-
County
Tomship
T " g d' "Oty" oryln, town 'ip)
Ce
Parcel nu her
013-
L a description .
Is pro
i question:
- _ v "
vt_VALUE'z6"
u i> 5
PQ
Real property ❑ Mobile Home (I.C. 61.1 -7)
If any portion of the residential structure or the Ian not exceeding one (1) acre that immediately wrrounds That lure U used b produce income, describe the use and ponlon
of the property utI¢ed to produce income.
R6P, ERTY, OWNEDrBYCI :AINWNT,IN:OTHER`COUNTIES
).,�}��t2 - ;,i:K,°rs'- awe! ^;?i
County
Township
County Township
hereby certify the above statements are true, correct and complete.
ture f cla'unant
dr ss nu era eet, ci ate, ZlPcode
Ire
Dale signed
vt_VALUE'z6"
u i> 5
Land not exceeding 1 (one) acre immediately
fee e- s•,.K. rr"'t`_Xi,S. ;yk _ _F
i'ASSIt R(USE 'ON LY, - rid' '
i- .:a rtR.
" 4TRUE TAX ���F
ASSESSED VALUE
3 HOMESTEAD
r,_.
3 fNON+RESIDENTU\L '
_rte'`sV_ALUEr
3t
AT 100 ° /a OF'TTV�VALUE4�
7 �f
Dale signed
vt_VALUE'z6"
u i> 5
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
O
i Ke,,.4..'�.. ..r..
Other land
2
()
?
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
a �"/J li hYyef -ir I
Residential Improvements
vemen
Assessed Mobile
Gars a
Other improvements
(6)
Total improvements (line 4 through line 6)
(T)
Total value (line 3 plus line 7)
(S)
I hereby certify the above is true, coned, and
Signature of Assessor
Date signed
complete.
Van" action - Signature of Auditor
Date signed
i?z .' STANDARD DEDUCTION ALLOWANCE,t ff j`';. ;';i'Q �-7 - ?9
20_Pay 20_
Lesser of 111 Homestead
Valuation or f35.000
Signature of Auditor
Dale signed