Homestead_Heldt 'SAlt r WRa.l`n,0./f+w nnrsSc nl FORM'MU
.VFMR'En nr Mar.WARD Of-Mn*,.srS.Ti+ eRr3Alhm BY TIM DFPARncc OF LOCAL no%ttMMrri FINANCE IC Vel!4.t
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 IndividuaLs and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than tier for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires uspayers who receive the homestead standard deduction to verify that they are eligible to=else the
benefit and to provide additional identifvine information necessary to allow county eo eminent to better monitor homestead
tiling..This information will he kepi coati-mint and can only he accessed by authorized county officials_The Depanmatt of
Local Government Finance sill use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Heldt, Ervin D/Shirley A
RI O
FRANCISCO IN 47649
1115
Ervin D/Shirley A Heldt
7650E 400 N State Parcel Number Legal Description
FRANCISCO IN 47649
26-06-21-103-003.265-017 009-03265-00 Pt Sw Nw 21-1-9 7.50 ac
'
Spouse First Middle Last
SA . elf y A,vft ffeLd T
Mailing Address(Number and street city,stale,and ZIP code) ® Same as property address
76 ,5 o E. 110041. rpphe scut, IA',
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.
PART 4: ADDITIONAL INFORMATION
CLAIM FOR HOMESTEAD PROPERTY TAX i FORM YEAR
CREDITISTANDARD DEDUCTION HC10
State Form 5473 (R6 / 4-03)
Prescribed by the Department of Local Government Fewke
owns the p6jWftRr g(PWil`1V6jd MT6VbacL
g _
,r��ra,.cN�'.'�`e`'�•l,�inwa< CONTRACT .'RECORDED- '�'t,�r,•�
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
.'�'
i' j3�vr�,a�__ ! ;_ ;,?PROPERTY,�ESCRIP.TION "�S.'.rt':Us ?rr�"✓ a ""_s€ ,.mss, '.� r 4 +', "°ti ;.
Co
Township
Taxing district (city, town o h"
ss (number and street, dry, state, ZIP code)
i
P cabs jj•��
Legal description
1
Is the pro
1
uestion:
zfs -Ll,
eal property ❑ Mobi omo (LC. 6.1.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that stlucture is used to produce income, describe the use and portion
of the property utilized to produce income.
P, R6P. ERTY, OWNEDIBYCLAIMANiJN6THER` C6UNTIES��.,:, _..:?FF�.>~:c ?.- *�,r"z'i5r`t��3
County nship
County Township
1 hereby certify the above statements are We, correct and complete.
Signature of claimant
ss (number and street, dry, state, ZIP code)
i
f Yc.J {3 i.GX.- 0z-
ASSESSDR,USE ONLY
TRUE TAX_,g
ASSESSED VALUE
4..
HOMESTEAD, Z
_
rNONtESIDENTIAL
?;n A�•yv�`.ry }_.,�,°i-
�{'r_VALUEH
"AT.700Ye'OFR'TTY . y
yVs.VALUE
`���VALUE'�;Y`
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
�58
Total land (line 1 plus line 2)
(3)
'Residential
Dwelling
(4)
�.� ..q� 3i•
.�;t +`?
Improvements or Annually
: .,uasAaEa ic:�
Asseeaed Mobile/ Manufactured Home
Garage
(5)
-;.. -.
-:'
Sc
. .'Sri:
Other improvements
(6)
} i�r7i
� z�C"
Total improvements (line 4 through line 6)
(7)
Trial value (line 3 plus line 7)
(S)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
; , �`+ rr?r`?#` ?`{ 5TANDARD !DEDUCTION'ALl'OWANCE';xi,
20_Pay 20_
Lesser of 112 Homestead
Valuation or 13Z.000 $
Signat of Nl Date sigrtCd ` � 0 ` 5 /1 6
