Homestead_Heldt (3) •
AME 10K!).'M nC/!•-0.1. rgr•uRER FORM 3 IA
MrmStn BY STATE BO MW OFMrY*PSlS._n.v ?RENCIUDIP DV Tim DEPARMENT OF LOCAL COW ItNNITNT FINANCE ICH.1_AI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individual and [married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than e'er for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
HEA 1374-2009 requires taxpa'em who receive the homestead standard deduction to verify that they arc eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to bener monitor homestead
filing-.This information will be kept confidential and can only be accessed by authorized county officials.The Ilepanmetu of
Local Government Finance will we this information to create touts that will help county officials eliminate homestead fraud.
PART 1:PROPERTY INFORMATION
Taxpayer Name Property Address
Heldt, George
305 N Main
FORT BRANCH IN 47648
6767
George Heldt
305 N Main St State Parcel Number Legal Description
FORT BRANCH IN 47648-1053
' I II III I II I IIII I I I I II ' I I II 26-18-13-402-000.136-020011-00136-00 WALLACE&FRENCH
r u tat t ton n nu nn t nt t tot t t Ise 278PT/279PT
PART 2:TAXPAYER INFORMATION
Owner I First Middle • Last
•ne Address(number and street,city,state,and ZIP code) — - ---_ - — - -- ame as pmpeny address
?/
Spotiw First Middle Last
Mailing Address(Number and street,city,stale,and ZIP cock) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please spctifv in Pan 4 below)
sane
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 Lhat,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date
Si�jF
�� s
a '
;���:
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2 / S92)
FORM
HC70
YEAR
�Cl1%
INSTRUCTIONS: See reverse side lor /iling instructions. ,
CE IFICATION STATEMENT
I(We) certify that on iheM�itla�bPFA�ictf!49_
I(We) occupied as our princi I lace of residence the following described real property for which a Homestead Prope�au Credit is here�claimed; :;
❑ I(We) owned ❑ re buying under contract VC-cn�� .�', I•: �`.;-+-<+_�-- .
/D n�_ c�: �. .
❑ Have a beneficial interest in the entity thai is liable for the property taxes on the propeAy and that owns the property ons�buy�ng under a coni'ractG� `
CONTRACTRECORDED -
It Duying on canvact, Fee Simple ownefs name -
Recorders oKCe where contmct is recorded � Record number Page
PROPERTY DESCRIPTION
Counry Township Taxing disinct (ciry, town, fownship)
Parcel numUer�O I^! � Legal descnption ^ m
\
�.JK/ (J
It any ponion ot the residential structure or the land not ezceetlirg one (1) acre that im ediatety sunounds that s ure is us o D�«luce i e, d ribe the use antl portion of
Ne property uulized to produce income. .
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Counry - Tawnship
Si tur daimant
ereb certiry the above statements are true, correct and complete.
dd ss (number and sVee4 dry, state, ZIP cotle)
3�a � � S� . lLf� NC a Z� �G� � Y�
ASSESSOR USE ONIY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediatey �� �
surrounding residential improvemenis.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Fiesidential improvements
Garage (5)
Other improvements (6)
Total improvements (line 4 through line 6) ' (7)
Total value Qine 3 plus line 7) (8)
I hereby Certify the above is true, corrett, and S'9^at��e of ��� Date signed
complete.
Verifying ac6on - Signature of Auditor Date signed
� ' STANDARD DEDUCTION ALLOWANCE
19_ Pay79_
Lesser of 1/2 Homestead S
Valuation or 52,000 � �
Signamre ol Auditor Date signetl