Homestead_Hartig 1115‘1,.:94 R}/s-lot IRASORLA 100.9 IS:A
APPRIaF➢nl a.UE arm°OF SQI•7.41-i]00 RISC PJMED III'➢Rn1PAR19GT01 LOCALCIWFA\LNT IDANCE.If 6-11-224.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
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 hom_statd fraud.Homestead fraud causes higher tax bills for all:therefore.
. II EA 1344-7009 requires taxpayers who receive:he homestead standard deduction to verify that they are eligible to receive the
FILED benefit and to prmide additional identifying :mbrmauon necessary to allow ninny government to betty 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 information to crsate tools chat will help county officials criminate homestead fraud.
PART 1: PROPERTY INFORMATION.
MAY 19 2012 Taxpayer Name Location Address
C �7 Hartig, Gary D/Gina A
904 CHICKASAW DR
GIBSON COUNTY AUDITOR FT BRANCH IN 47648
7632
Gary D/Gina A Hartig II I[I Iii[III U I U Dlll llhI I[III VU III 1 llQ 11:111[II I1 II III_�II�II01�111���
904 Chickasaw Dr
Fort Branch IN 47648-9539
I1I1III111II1' 'Illllll1lllll1t11II1I11III1ttlllllrllllltlllrlrll State Parcel Number Legal Description
26-19-18-101-001.013-026 LITTLE YORK VILLAGE 35/36 N1/2
PHASE 1
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
_r I Middle last
ORCC Beer& -
Mailing Address(number and street.city,state,and ZIP code) ®,Same as property address
?c4 ?j-Fic I,4SA1 / told,brerA-C 1 2103 97& </8
Spouse First Middle Last
�sL.f4 Aw/0 IA t e."--
Mailing Address(Number and street,city,state,and ZIP code) r.LSame as property address
'CV e- AS 3)e toner-ie , -Lk) . 476. vs
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 Sig re Date
a.E ^'"'°„ CLAIM FOR HOMESTEAD PROPERTY TAX � FORrn YEAR
; �: CREDIT/STANDARD DEDUCTION HCio
,�;;'� State Form 5<73 (R2 / 5-92)
�eu
INSTRUCTIONS: See �everse side !or 7iling instructions.
' ' . • CERTIFICATION STATEMENT
��) ���� ��."j� cenify that on tF��l�d hf�t9_
) occupied as our prin a place of reside the following described real property for which a�Homesiead Property Tax Cre i is he�e�b�y�laimed:
�! I(We) owned ❑ Are buying under coniract � a. �
������
❑ Have a beneficia� interest in the entity that is Iiable for ihe property taxes on the property and ihat owns the property or is ntract.
� . CONTRACT RECORDED . - .
It buying on contracC Fee Simple owner's name _ �
Recorder'S oftice where coniract is retorded Record number Page
C.OUf1i}'
Parcel number � Legal description
PROPERTY DESCRIPTION
Tauing di5trit� (ciry, tOwn,
simciure or the IarM not exceeding one (7 � acre thai immetliately surmuntls that structure is used to produce income. describe the use arM portion
ice income.
ASSESSOR USE ONLY THUETAX ASSESSED HOMESTEAD NON-RESIDENT7AL
VAIUE VALUE VALUE � VALUE
Land not ezceeding 1(one) acre immediately .
surrounding resideniial improvemenis. (�)
Otherland (p�
Total land (line 7 plus line � (3)
Dwelling (4) �
Resideniial improvemenis
Garage (5)
Other improvements (6) �
Total improvements Qine 4 through line � (7)
Total value (line 3 p�s line 7� (g)
I hereby Certify Ihe abOVe i5 irue, CorreCi, and SignaWre of Assessor Dare signeC
complete.
�tying action - Signamre of Audiror Date signed