Homestead_Zetina SIAEE I OR.M SM.01:”4/.1 TRFAAIIIR FORM:31A
APPRIT ED BY E Tad[WARD OF MYYR4\Tl.2I' PArgRlnm aY nlr DEPARTfEYTIDFLI AE GOVERN R.J Fe::sCE IC41.ISr.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to OW homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than net for homestead fraud.liomestead fraud causes higher tax bills for all:therefore.
HEA 1344-3009 requires taxpayers who receive the homestead standard deduction to verify that they are cligibe to recent 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 ran only he accessed by au=Mrired county officials.The Department of
Local Government Finance will use this information to create toots that %rill help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Zetina, Elaine K
R 2 Box 569
Ilaubstadt IN 47639
3062
Elaine K Zetina
401 E Church St State Parcel Number LeEal Description
Haubstadt IN 47639-8211
111111,1 26-19-31-101-000.451-009 013-00451-00 ELPERS NEUMAN 4
. , __. — — -- . _ _ _
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
Owner I First Middle 1 Last
F/0/ 7e /t)0)
Ig Address(number and street.city,state,and ZIP code) ® Same as property address
rA rid 57 //avbs / ,r// L ) /2c ,' 9
Spouse / First / Middle Last
Mailing Address(Number and street,city,state,and ZIP code) Ai Same as property address
//O/ d4 vine& 574 u a
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
- - _
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
CLAIM FOR HOMESTEAD PROPERTY TAX FORM' YEAR
CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R6 I 4-G3)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
I (We) t f C'� 0 T�� I I 10 f � certify that JAN I PaAtrch, 20_
I (We) occupied as our principal place of residence the follong described real property for which a Homestead Property Tax Credit is hereby claimed:
a) 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(MeM w_j3@*#rV A40f1aWbntract.
CONTRACT, RECORDEDI.,,,.'o�-,�,�,
If W09 on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
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PftOOERTY.,DESCFilPTION�s:wf'E.t;e:�!,�
County
Township
Taxing clistrict town township)
Parcel number
L I d Is - the proparIV In question:
—
L*7 OQ1 property ❑ Mobile Home (/.C. 6-1.1-7)
one If any portion of — r 11 that immediate surtounds N structure is used to produce income, describe the use and portion
of the property utilize
JO
County Toiinship
County
Township
I hereby certify the above statements are true, correct and complete.
Signaj.%uepf claimant
ress (number and smeet, city, state, ZIP code)
-AT,100%OF�T.TVA'�-'-'---�VALUE
JO
TRUE,TAX ��`,:
ASSESSEDMALUE
H6MESTkAD'---
4&
��-G 1, U5E ;
-AT,100%OF�T.TVA'�-'-'---�VALUE
•ASSESSOR
Land not exceedin .9 1 (one) acre immediately
surrounding residential improvements.
A
'
Other land
(2)
Total land (fine I plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
(5)
.Otter improvements
(6)
Tctal Improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby car* the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
..-.r, a�-v.;-,'STANDARD_DEDUCTION'ALLOWANCE,_,,.
20_ Pay 20_
Lesser of 112 Homestead
Valuation or 335,000
$
Signature of Auditor
Date signed