Homestead_Kleiman RATE EORN153 Vx1R'(rwm MASURIR FORM IS-IA
APPROVED BY MATE&MAD Of AM CMS.!VN PRES(WamaY fir DEPARTMENT OF E(CAE GOVERNMENT FINANCE w 4-I.t-Z3.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
r PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction become,
more beneficial.there is more incentive than ncr for homestead fraud.linmestead 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
tiling, This information will he kepi confidential and can only M.accessed by awhorLed county officials.The Repanment of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address C '
Kleiman, Lonnie A Trust I O zs C 5 a 6.0 L
ox?1?
cd IN 47613
8867
Lonnie A Kleiman Trust
10259 S 850E State Parcel Number Legal Description
Elberfeld IN 47613-8404
ItInIIntItII Ilu�ltlnIuInIIInnInItIt ItItInItIt tI 26-20-33-400-000.416-001 001-00416-00 PT SE SE 33392 AC
/
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Lo 0 iu 2-4 A? r4 r- _7-AinzA/
ig Address(number and sates,city,state,and ZIP code) 1:21.Same as property address --
/D259 S SSO E EAsk/enE}Dz� 4 ? / 3
Spouse First Middle Last
uvinowfR �-
_ Mailing Address(Number and sweet,city,slate,and ZIP code) E Stone as pmpeny address
—fl,Z-TSc:adiytiuof Hat3 digits)—t-DrisfL cttsCStat iD Number (last 5 digits) Other(please specify in Pat 4 below)
so=
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.
OwgtTamrc Date
C--- \ . )
PART 4:ADDITIONAL INFORMATION
•
FORM HC 10 1979 To Be Filed in Duplicate
Prewtllped By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 1929
SEE BACK FOR FILING INSTRUCTIONS 00 /- O0,/ -/6 ,
(We) KO�1�a�a certify that on the 1st day of
,,arch, 19 I, (We) occupied as our princip place of residence the following described real property for
which a1Homestead Property Tax Credit is hereby being claimed:
I, (We) l;p owned -�0 _ �3 �- 4W . jG -�101
❑ are buying under contract
❑ have a beneficial interest in the taxpayer ,c
Property Description in A/ County Township
Taxing District (G4, TewR, Township): A?a-4-62�
Parcel Number or legal description shown on tax statement:
oet's y SEy .33-.3--y oL QoAe.,
If buying on contract: Owners name ('ee simple owner)
Contract recorded in Recorders Office - Record No
If any 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
Any other counties in which individual owns buying real property:
'-hereby _ certify the above statement is true, correct and complete.
A /-.e A ,A1
County Township
Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
Approved
-29
Assessed Homestead
Valuation Valuation
120
.9
Dave
Date:
FOR ASSESSOR'S USE ONLY -
True Cash
Value
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
(1)
Other Land
Total Land FILED
(2) v
(3) S o
Residential Improvements
Dwelling
(4) / 7 7 i/o
.JUN 2
. '1979
(5)
Garage
/1 �f
Total
(6) __L _l 7 `moo
Other Improvements
AUDITOR
(7)
T�' ' Improvements - Line (6) plus
Wy
(7) equals (8)
(8) / 9 3.3 o
l certify..the above is true.
correct, and
complete.
Signal a of Assessor
-
f r
ACTION
BY AUDITOR -
Approved
-29
Assessed Homestead
Valuation Valuation
120
.9
Dave
Date: