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Homestead_Zehner • STATE FORM 535e4(53l&lq TREASURER FORM TS-IA - APPRO4'En/IV STATE BMW OF ACCOUNTS_NO9 PRESCRIBED fly HIS DEPARTMENT OF LOCAL GOviaNMEWr MHA`IE le b1.1-132.1 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 tax bills for all;therefore, FILED T T E T HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the • L "'1 L 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 Deparunenr of Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.. APR 2 6 2011 • PART I: PROPERTY-INFORMATION - - - C V Taxpayer Name Location Address Zehner, Amber D GIBSON COUNTY AUDITOR 117 S WEBER DR HAUBSTADT IN 47639 2370 0 Amber DZehner 110111��_�� 1110IH��1111lU11WII1��11W11)111[lO��111III��Ill1101111l 117 S Weber Dr HAUBSTADT IN 47639-8130 .. IILIII'llll'I'lll'Ill'Illlllll'II'II'llllll'1I11111F�lllll'lll'll State Parcel Number Legal Description 26-18-36-404-000.372-009/WEST HGTS 2ND ADD 700 A • 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 INFORMATION . First r ( Fi - Middle .• ,`Last A42 a 1 n A64e2 Cf�,i--# Mailing Address(number and street.city,state,and ZIP code) - ErSame as property address i � //7 J.. 1`t fXe OzJe Spouse _ First Middle _ Last Marling"Address Numtiaandsaect:ci ry—,state.andZIPcode --- — _ - , "'`--`T Er '_ --.-- - 7-- " ' ' Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below) l l I 5uu - 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. Ownerll S.:. lure Date PART 4: ADDITIONAL INFORMATION . CLAIM FOR HOMESTEAD PROPERTY TAX O EAR t CREDIT /STANDARD DEDUCTION p State Form 5473 (R817 -07)° J Prescribed by the Department of Local Government Finance MAY 1 2 2009 INSTRUCTIONS: See reverse side for filing instructions. I (We) p.! Lam/ GIBBON COUNTY AUDITOR certify IB O the 1 at day of March, 20_ I (We) occupied as our principal place of resid the following described real property for which a Homestead Property Tax Credit is hereby claimed: Ilk] I (We) owned El Am A 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 under a contract. CONTRACTRECOR . . If buying on contract, Fee Simple owner's rams Recorder's office where contract is recorded Record number Page County Township I hereby certify the above statements are true, correct and complete. and street' city. state, County ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD NON-RESIDENTIAL PROPERTY DESCRIPTION County Tovnship Taxing district (city, town, township) Parcel number Legal descdption A69i '7 J / Is the property in question: A A01 CjCjVLt!P--j ❑ Real property ❑ Mobile Home (IC 6- 1.1 -7) If any portion of the residential structure or the WrW not exceedi ne (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of Ins property utilized W produce income. von- 0x60. 3 >a - a ©9 County Township I hereby certify the above statements are true, correct and complete. and street' city. state, County ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD NON-RESIDENTIAL AT 100% OF TTV VALUE VALUE Land not exceeding 1 (one) acre immediately -,. }`.:�. ,• �r F ` " surrounding residential improvements. ;� Other land (2) Total land (line 1 plus fine 2) (3) Dwelling (4) Residential improvements or Annually eN Assessed Mobile I Manufactured Home Garage (5) >�..: • ; y':..,.,: Other improvements (6) Total improvements (line 4 through line 6) (7) , Total value (line 3 plus line 7) (8) 1 hereby certify the above is true, cortect, and Signature of Assessor Date signed (month, day, year) complete. Verifying action - Signature of Auditor Date signed (month, day, year) 20 _ pay 20 Lesser of 12 Homestead Valuation or Signature ofA dtor 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011 44,000 for 2008 pay 2009 41.000 for 2011 pay 2012 43,000 for 2009 pay 2010 40,000 payable after 2012 Date signed (month, day. year)