Homestead_Dekemper STATE FORM!3,eilrt 4"1 TPlsStJW 1010 179-1A
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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 exer for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
' la HEA 1344--3109 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to:grebe the
benefit and to provide additional identifying information necessary to allow county goverment to better monitor homestead
filings.This information will he kept confidential and can only he accessed by authorized count'officials.The Department of
Local Government Finance will use this information to create lads that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
Dekemper, Darrell/ Darcy Douglas
402 S Cumberland
Fort Branch IN 47648
2587
Darrell/Darcy Dekemper
402 S Cumberland
Fort Branch IN 47648-1528 State Parcel Number Lesal Description
l r t r r l l r t t l l l l l l l i I l l l l l i r r t r l l l l F l l t l i I l l r l i r l l r r r r l lull 11t1 26-18-24-202-000.277-026/ 011-00277-00 BERTHA LINTZ 14
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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.
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
�� 441/44/1/ tie:me 4 �.:7,r.
�ng Address(number and street,city,state,and ZIP code)) Same as properly tdWess
90 a S. Cam 4‘444,1 SI ATkit .Q/)'decii fS Y74 %f-/fn8
Zoe- �� Last
b4 &0v L-yAid .00 if514SAl .n,t)ft •
Mailing Address(Nutnkr and street,city,state,and"LIP code) ig Same prpenv address :/
you s C/&nLp /A4,I5r- Pr) Al DAAJY01 f-;)/. 97l �/7
—Each undersigned certifies,under penalty of perjury,jhat 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
unlaw.fttlly,he or she may be liable for back taxes and substantial financial penalties.
Signature Date Telephone
4 Z).2-Si : 1-2_ /0 ( 8 (2) y3/- yao,3
Spouse Signature Date Telephone
i • . 1.,, S l.7-70 ( p/(2 ) 5 s99a-.
PART 4:ADDITIONAL INFORMATION
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn Sa73 (R2 / 592)
FORM - YEAR
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u�o�nvw�vrva oee ievmoe �me m� umy mouwu�na. M�p p
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CERTIFICATION STATEMENT �?
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I (We) - -� c��� 19_
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�1(We) occupied as our principal pla of reside ce the foliowing described real property for whi omestead�Prbperty:73x Cr¢tllt' claimed:
�(We) owned ❑ Are buying under contract
ave a beneficial interest in the entiry that is liable for the property�taxes on the property and that owns the property or is buying under a coniract.
CONTRACTRECORDED
It buying on contract, Fee Simple ownefs name
Recortlefs off�ce where conVact is recorded . Record numDer Page
PROPERTY DESCRIPTION �
Counry Tovmship Ta�dng district "ry, fo�m, townshrp) �
Parcel nIumber Legal description
� � ` � � �
It any ponion of ihe residenfial struMure or Ne land not exceeding one (1) acre Nat immediatey surrountls that sWCture is useU to protluce income. descnbe ihe use antl ponion of
Ne property utiiized to protluce income.
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Couniy Township Counry Township
SignaWm�[claimani � ��
' .ereby certity the above statements are true, correct and complete. �
Adtlress (number and treef, ", state. ZIP codel '
�o . �".zz` �-. y�6 y�
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately (�) �
surrounding resideniial improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Resideniial improvements
�Garage (5) - -
Other improvements (6)
Total improvements (line 4 th�ough line 6J (7)
Total value (line 3 plus line 7) . (8)
1 hereby certify the above is true, cortect, and Signature of Assesor Date signed
complete.
Verifying action - SignaWre of Audimr Date signed
�� STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _ .
Lesserof 1/2 Homestead S
Valuation or 52.000 �
SignaWre ot Auditor Date signed