Homestead_SchroederCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Slate Form 5673 (R8 17-07)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
?I M-0
7 •- I �
FEB 2 7 2009
I (We) 10CJVLOV.4DkGA, cerfif�x ItthghaaStnn1nnJ the day o6%rch, 20_
I (We) ocwpied as o rind pal place of residence the following described real property for which a Homeste K i PWWRIaimed,
rrl I (We) 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 property or is buying under a contract.
CONTRACT ••D s
If buying on contrail, Fee Simple owners name
Recorders office where contract is recorded Record number Page
County To mship I Taxing district (city, town, township)
Parcel number Legal descdpu ( Is the property in question:
Q1� �� ❑ Real property ❑ Mobile Home (IC &1 -1 -7)
Its portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce Income, describe the use and portion
of the property utilized to produce income. q0 •qx• jqC_
ASSESSOR USE ONLY
TRUETAXVALUE
ASSESSEDVALUE
HOMESTEAD
NON-RESIDENTIAL
Homestead
e ad d Valuati on
or 43,000 for 2009 pay 2010 40,000 payable after 2012
AT 100% OF TTV
VALUE
VALUE
Land not exceecring 1 (one) acre invnediately
surrounding residential improvements.
(1)
Other land
(2)
-,
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
-
::- �; - :• :`_ ),,,'- _ _,. ;.. :' _ -
Assessed Mobile I Manufactured Home
Garage
Other improvements
(6)
Total improvements (line 4 through fine 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is We, Coned, and
Signature of Assessor
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day, year)
STANDARD DEDUCTION
_ pay 20 — 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of I
44 000 for 2008 pay 2009 41,000 for 2011 pay 20
S
Homestead
e ad d Valuati on
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Audits
Date signed (month, day, year)
•
%LATE HAM MY"ICt•wl lfrISUEE{WILY:}IA
APPROVED DT ST OE aMRDM'1Avit ax._n!r flrnmm BY THE DEPARTMENT OF LOCAL aw?RNXrwr FINANCE teit.t.na l
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 eser for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
•--
HEA 1344-2000 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reeeise the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
Minter information will be Let confidential and can only he accessed by authorized county officials.The nepanntent of
Local Government finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Schroeder, Tony F
305 S First AVE
Boonville IN 4 7601-1 709
y ILfI
Ton
ToF Schroeder
5117 E 500 N Markford Rd State Parcel Number Legal Description
Patoka IN 47666 APR 1 2 2010
26-05-57-120-000.681-017 009-00681-00 Pi MD 120 1-10 40.48 AC
--'yyam� C-1
praa / ,
GIBSON COUNTY AUDITOR
PART 2: TAXPAYER INFORMATION
Owner I 07111-(� First /� T Middle Last
Om Address( umber d street,city,state,and ZIPcodc)- - - --— - --- - -O Smitc as property address - -- "--
J E '7t oN /11/4,121e- /earl) feai1 f�A dKi�X11/ ?C 6
-.
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's 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 Sign lure
Date
0