Homestead_SchatzCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
t CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R6 / 403)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing inslmctions.
(We) S +G-C SCh a..-�- Z et J%--j that on of'Mjf°ii, 20_
I (We) occupied as oui pl{ndpal place of residence the following described real property (or which a Homestead PgoMe a�L��4 r aq I� hereby claimed:
B(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 own_ he property of is buying under a grjntract.
If buying on contract, Fee Simple owners name
is recorded
AUDIT ^^
Record number I Page
Township
I hereby certify the above statements are We, correct and complete.
(number and street, city, state,
Township
SJ;� ;�T'E'�''� -`''�— 'z
�*- ASSESSOR�USE ONLY
Court
b
Township „//��
)V-
Tatting district (cify, toWq tow� hip)
I-e-itt,J
f s a
.,1!a�>:r�•.Ob�.c::— �"E- �.Ak`:
A42-
Parcel number
Le a] descnodon
�'1'r VALUE f.�`��.i'"�5,
Land not exceeding 1 (one) acre immediately
Is the property in question:
O (!4: It) O 1 77O O
F, F— �
1 ti t
surrounding residential improvements.
L` kR property ❑ Mobile Homo (l.C. 6-1.1 -7)
If any portion of the residential structure or the land not exceeiYng 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.
Township
I hereby certify the above statements are We, correct and complete.
(number and street, city, state,
Township
SJ;� ;�T'E'�''� -`''�— 'z
�*- ASSESSOR�USE ONLY
:1TRUE�TAXe t
T�e-
ASSESSEDVALUE
F1MESTEADn
`'', NON E-R SIDENTIAL
�
.,1!a�>:r�•.Ob�.c::— �"E- �.Ak`:
vwVAL.UEL' �?.�.
AT 100 %TO.,,F�TTVd
�SiTt: VALUE�;+rayt
�'1'r VALUE f.�`��.i'"�5,
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
a1 �'-
d„
Residential improvements or Annually
Assessed Mobile / Manufactured Home
Garage
(5)g.8
” '.;�
r.
s:.Y2'
-
Other improvements
(6)
I 'ti Y y ON
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
4,13 —o
;J'�' r=STANDARD DEDUCTION"ALCOWANCE
® 20 _ Pay 20
Lesser of 1/2 Homestead $
valuation or 535.000
Signature of Auditor \ Date signed
0 == q — a1- 3 J
■
- S . -
, STATE FORM 535&(R)/&10) TREASURE,FORM TS-IA
APPROVED BY STATE MART OF ICCOUYTS.MP FRESCRBIra BY THE DFPARMEST OF LOCALCOVERLAMENT FINANCE K.61.1-Ua.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
• fir- �' ,∎ fingst and i ti provide additional identifying confidential itial and can necessary to allow county government officials.ciaer monitor homestead of
llgll / I filings.This information will be kept confidential and can only be accessed by authorized comfy officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud
PART I: PROPERTY INFORMATION
_ DEC 2 7 2011 Taxpayer Name .
Location Address
C Schatz, Stacey D
108 S INDIANA ST
' GIBSON COUNTY AUDITOR HAZLETON IN 47640
275' i II II II
Stacey DSchatz IIIIBIIIIIIIDIIDIOI hilt I_III [Il�llll_II_ miI_II_IlIDIllhl inIIIi illOHIlullll
C/O Stacy Ivers •
108 S Indiana ST
Hazleton IN 47640-8900
I11t1llllII'lllI"llllltt 1111"IIItIlltlIIllIIIII'II"IIIIIIIIIlI State Parcel Number Legal Description
26-02-59-033-000.277-019 E ENLG 108 PT
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.
. . i- '4 - ` g ' 8 p/� .
Ow..afaceY First �n CS) n Middle �UEXC.S Last
Mailing Address(number and street,city,state,and ZIP code) F-� Same as property address
los> S. EucilAtti( 5 1-1-42JE4oxsj L.- CO
Spouse First Middle Last
--
Mailing Address(Number and suet,city,state,and ZIP code) El Same as property address
Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
I I I I I I I I I State
. 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.
Own Si tune Date
.Signature Date Telephone \1
( )
PART 4: ADDITIONAL INFORMATION