Homestead_KremzarC
FA
•r
CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD /SUPPLEMENTAL DEDUCTION
State Farm 5473 (R1216 -09) -
Prescribed by the Department of Local Government Finance
INSTRUCTIONS., See reverse side for filing instructions.
APR 2 0 2010
-CERTIFICATION STATEMENT.
I(We) A9&_V7,ja ceftifyth1f3R&A "NgIAyAV0WOF1l1I
place de5cribgrl real property for which a mast d Property Tax Standard Deduction is hereby claimed
under contract on the date this application is filed, �j' Z'� /0 (date of filing):
I (We) own ❑ Am (are) buying under recorded contract
Am (are) entitled to occupy as a tenant - stockholder of a cooperative housing corporation
Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust
CONTRACT RECORDED
If buying on wnuact, Fee Simple owners name
Recorders office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County
Township
Taxing distnc( (rJty town, township)
Parcel number
Legal description '1 o, d -7lqC Ds the property in questiqplf
1
P 1 —to ❑ Real property E] Annually assessed mobile home (IC 6-1.1 -7)
any portion of the residential structwe or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
'If
of the property utf aced to produce income.
0�& -oa -57 -iii 7
PROPERTY OWNED BY
County Township - County 7p
I hereby certify the above statements are true, correct and complete.
signature of t
Address (n ,andsimst. state, a Z/Pcode
�� 1i•51�- �ETG.I/
r r r
ASSESSOR USE ONLY
I AT 100% OF TTV I VALUE VALUE
Land not e:ceetling 1 (one) acre immediately 5�: 43t {`��+ -'f +`- •-y`T'
surtoundin residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Mow Sa+�s a"3,.r+•. .,f`�•s � F
£`ZU
Residential Improvements or Annually
�.s;: XX-- 1Z
Garage
(5)
Assessed Mobile I Manufactured Home
Other improvement
(6)
Total improvement ( line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct,
Signature of Assessor
Dam signed (month, day, year)
and complete.
Verifying action - Signature of Auditor
Dam signed (month, clay, year)
STANDARD DEDUCTION
20 pay 20 _ Lesser of 60% of the assessed value of the homestead or 545,000
Notwithstanding any otherprovision, the sum of the deductions provided in IC 6-1.1 -12 to a mobile home that is
5
rat assessed as real property or to a manufactured home that is not assessed as real property may not exceed
one-hatl(12) of the assessed value of the mobile home or manufactured home.
Signature of Auditor
Dam signed (month. day, year)
STATE FORM 5356Q OW 8-10) 19F..8.1 TEA FORM T5-IA
APPROVED BY STATE BOARD OF ACCOUNTS.203Q PRFYRIum BY T1EDFPARTMEA-r OF LOCAL GO VERMAEYT FIANCE IC 61.1-}}A.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,
• 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
Local Government Finance will use this infonnation to create tools that will help county officials eliminate homestead fraud.
.: PART 1: PROPERTY INFORMATION
Taxpayer Name Location Address
Kremzar, Max J/Helen
3988E SR 56
HAZLETON IN 47640
1665. •� .
MaxJ/HelenKremzar 1111 III 11IIII IIII1II3111011fll1TII miliL IlIUII011 111 1 111111
3988 E SR 56
HAZLETON IN 47640
State Parcel Number Legal Description
FILED26-02-57-111-000.447-017/PT MD 1111-1070.27 AC
APR 19 201
c. .rr\-- -----
UNTY AUDITOR
This fbrm`�I�IUST be returned to County Auditor's office.
,
Spouse First Middle Last
//14.e- s K2 "1/0-14,2
Mailing Address(Number and street,city,state,and ZIP code) u Same as property address
39 88 CSR 15 6 /9gzzgTB/1/ /A/ 476
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 fmancial penalties.
PART 4: ADDITIONAL INFORMATION