Homestead_Weiss STATE FOtM!!H,C/% 'I TRFASURFA FO*N TS-IA
.ATWWEn BY MAIL ws o or anrCII,Naa.!in tlr5[Rmm(DOY um orPAREMFVT IF Waal.0 VERNMrn FINANCE It 6-I.1-r4.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standanl deduction.As the receipt of this deduction beconms
more beneficial.there is more incentive than ner for homestead fraud Homestead fraud causes higher tat bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to rrceue the
benefit and to provide additional identifying information neceszry to allow counts.government to better monitor homestead
filings.This intbrmation will be kepi confidential and can only be accessed by authorized county officials. the Ikpannsent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
Weiss, Glenn R
11 I S Jeremy Lane
Ilaubstadt IN 47639-5 160
7366
Glenn R Weiss
111 S Jeremy Lane State Parcel Number Legal Description
HAUBSTADT IN 47639-8160
'lIIIIIIII'tlilltelllltlllllllltiiiiiiIiIII IIIIIIIIIIIII 26-18-36-403-000.531-009 013-00531-00 WEST HGTS 3RD ADD 311
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
G Jcrni 8x - /tie l c_s-
allAddress(number and siren,city,state,and ZIP code) j J Same as property address - --
Spouse First Middle Last
Mailing Address(Number and street,city,state.and ZIP code) [J Same as property address
Social Security Number(last 5 digits) I Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below) - - _
-
sow
- 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 Signatu c Date
)
PART 4:ADDITIONAL INFORMATION .
II
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R715-06)
Prescribed by the Daperbnant of Local Goverment Finance
INSTRUCTIONS: See reverse side Ibr Sma insirtictions
F' Y&R
U r- L . 2
I (We) Z�- Q/ri/R--� -IT-- • why omfiry that on the 1st day of March, 2D —
I (We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
I (V*) owned ❑ Are buying under contract
Have a beneficial interest in the entity ffiat is liable for the property taxes on the property and that owns the property or is buying under a contract.
C ONTRACT. REC ORD
ff hrftV on ..bact, Fm Simple o~s narrm,
Ractirdels office where cantrad is recorded Record number Page
`e�PROPEJRTY IDESCRIJ, W."
noWW" ., "M, , ,
", 11
County
TONFIShip
(oly. �. fownship)
ITownship
Parcel number
Lao desorption
Is the prop" in question:
(nurnba, ad street W state. 707 7 / 1119
1� t �:�V Zane oJ�� JrA VW1
S
I
I ❑ Rem mpary
EIM.W1. H. (LC. &1.1 -7)
der structure or the land not exoeedinii 6m (1) acre that Frunedialely suffourlds dud shuclure m used to produce �, deambe the use and portion
ZIF=—
preparty -
0 3 -0D0- -3 0 0
FA
` . , d , I'l "�,
ONLY 110S,
<:7rxk
County
Township
I County
ITownship
I hereby certify the above statements are true. correct and cornplete.
IT–
(nurnba, ad street W state. 707 7 / 1119
1� t �:�V Zane oJ�� JrA VW1
S
FA
` . , d , I'l "�,
ONLY 110S,
ME
20— Pay 2O—
NON Ar
Lesser of 12 Homestead
IT–
S
Signature of xdtor
Date signpd
/ Slo 7
Land M exceeding I (one) am urmnediataly
-wg
wffmrvd#V residential unprovernents.
Other land
(2)
Total land (thm I pkis &m 2)
(3)
Dweffing
(4)
Residential anprovervmts or Annually
Assessed Mobile I h4anufachxed Home
Garage
(5)
Other improvements
(6)
Tdal anprovernerds (firm 4 thrmigh fine 8I
(711
Total value (fine 3 ph& &* 7)
(8)
I hereby certify the above is true, correct and
cornpieta.
Signalure of Assessor
Data Signed
%krzfprig action - Sqnaturs at Au*W
Date signed
20— Pay 2O—
Lesser of 12 Homestead
Valuation or 535,000
S
Signature of xdtor
Date signpd
/ Slo 7