Homestead_Vogler STATE FORM SIkC(Rll 8-10) TREASURER VOMITS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,1C09 PRESCRIBED BY TUE DEPARTMENT OF LOCAL GO TASMEYr FINANCE IC 41.1.11-0.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one 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 in 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.The Department of
A■■Fy,' Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
' PART 1: PROPERTY INFORMA"PION
•
Taxpayer'Name Location Address
JUN 0 3 2011 .Vogler, Aaron A .
308 S Vine
. 0 1I111 - Haubstad_t IN 47639
21J80N COUNTY 11011101 1111- 11101lI . UI Il1101IIII_ 00
0 ]I1 1111
Aaron A Vogler
308 S Vine St
HAUBSTADT IN 47639-8151 •
IIIIIIIIIIIIIIIIIIIIII111111111111111111111111111 1111111111111111 State Parcel Number Legal Description
26-19-31-303-000.038-009 ORIGINAL PLAN 244/245/246
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.
l PART 2: TAXPAYER INFORMATION
OM I A First - _ Middle Last
Mail in?Address(number and street,city,state,and ZIP code) ne as property address
Spouse - First - Middle Last
— Mailing A"ndress-(Number and street city,state,"and ZIP code)___ _—� _ ___ - — —0-fie as __._ —__ - _-
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
1 I I I I 1 I I I Stale
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
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R614 -03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM
1 � YEAR
HC10
PRTIFIqVnON
STATEMENTS
Township
I (We)
certi March, 20
I (We) occupied as our pdncipal place of residence the following des
ed real for Homeserlit"
P I er
Legal descdpfion
Is the property in question:
property which a
fEstridpor
er y Imed:
I (We) owned ❑ Are buying under contract
of the property utilized to produce income.
Have a benefidal interest in the entity that is liable (or the property taxes on the property and that owns the
properg pf js
guying under a contract.
tr�•_v i' ti - x.�. -..0
.'i�d�. ✓j��•,-�.>.�v�+3.� ��a.. ;i; a 4�;zw.<CONTRACT'RECORDED rs�s�',�.' ��ls'ya -'�i1 :���n a A; :+as^ -af �.'•1
If buying on contract. Fee Supple owner's name G •+
GIBSON COUNTY AUDITOR
Recorders office where contract is recorded Record number Page
rg
PROP,ERTY�DES .. w/� �-
County
Township
Taring d" (ci
03
Signature of a
Address (number and street, city. state, ZIP code)
P I er
Legal descdpfion
Is the property in question:
2' +TRUE TAX 3-
eVAI:UE`?..
ASSESSED VALUE
AT: 100% OF. TiVI�
property ❑ Mobile Home ( /.C. 6- 1.1 -7)
If any portion of the residential structure or the land not 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.
P,ROP.ERTY OWNEDIBY CL'AIMANT.IN:OTHER'000NTIES �' `x;;sj�;�c'`�`b`�1ij.3�"":dee�T �'r-,;
County
Township
County Township
hereby certify the above statements are true, correct and complete.
Signature of a
Address (number and street, city. state, ZIP code)
Valuation or 836.000
r.fir- "ASSESSORUSEONLY S..y � "-
w'r., ?o- "._.`_
2' +TRUE TAX 3-
eVAI:UE`?..
ASSESSED VALUE
AT: 100% OF. TiVI�
_ y
HOMESTEAD,y
sre�&I r Y+
NON= RESIDENTIAL a
..- _'?�:'rtaP-
ii43:VALUEr.-
..'.S1VAL.UE�i€
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
9
()
(Residential improvements or Annually
-''� 4J r7~
Assessed Mobile I Manufactured Home
Garage,
_
Other improvements
(6)
Trial improvements (line 4 through line 6)
(T)
Trial value (line 3 phs linen
(g)
hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
c: z,,.; t�. �. 3•', J,,.< �r,' �' �, u• �: ixi�,, a�E:- �;` j§ �' a` '—;Lw' �_ r_ �,, iSTANDARD
;DEDUCTIONiALCOWANCE,..m?:
20_Pay 20_
Lesser of 112 Homestead
Valuation or 836.000
8
Signature of Auditor
Date
V V V