Homestead_Kramer (8) STATE FORM 53569(R,9-09) TREASURER FORM TSIAI
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.1 22_-S.I
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
�
rduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
auses higher tax bills for all; therefore, HEA 1344-2099 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 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 create tools that will help county officials eliminate
homestead fraud.
PAR I: P'OPERTY INFORMA ION _
Taroarer Name Property Address State Parcel Number Leal Description:
Patrick A/Karen L Kramer 505 E Strain 26-19-19-101-000.164-026 011-00164-00 EASTVIEW
Fort Branch IN 47648 sr'/ IOPT/13PT
Complete and return to:
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2: TAXPAYER INFORMATION
er 1 First Middle Last
iiletl:,W A lie 10 Klel9Vl',t ve
Malting Address(number and street city,state and ZIP code) I 1./5ame as property address
So ce+5 S.�,en;N Foie 4- BeANa rt/. Li 7ii, v8
Last
1<& EP Z i N Ai • 1C2 14 ',we �
Mailing Address(number and street.My.state and ZIP code) / // Ime as property address
SOS E 57Ael;.0 FONT Er2AN c GV ZN- si--76 V
—
.. y - - -_ _ _- 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.
eeciA . ,, ,,ana____
1 Signature Date
PART 4: ADDITIONAL INFORMATION -
a ' ' -
"rUP;.i ML 1U 19l5
P�=scn�ea 8; S�a:x Boa�O ot iax Commissiontu
CLAII� FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19_�_�L._
lU Ot i IrJ n Ui�ItaL
9/
I�'e) V U_JVLA..c f� / � �/`�.VWYI o� ! VIX.C/Yn11J� certify that o� the 1st day of
A-,_ h, 79�, I, (We) occupied as our principal place oi residence the following described real properiy (or
which a Homes[ead Properiy Tax Credit is hereby being claimed:
'/ `�_ d0
I, (1Ne) owned ���� /��1�(�
❑ are buying under conVact ����
❑ have a beneficial interest in the taxpayer
Property Description in County '/� ' _ Township
Taxing District (City, Town, Township): �� r� �`�
Parcel Number or legal description shown on tax statement:
�ui 1 � , � _„� 1 �'C.����..n..a...�r I 0 °�' f �3 �—
-, �-�.�,�L''_�)V'
�i buying Ofl contract: Owners name ��ee simo�e u..nerl
2 � l��
����`� '"�� Contract recorded in Recorders O(fice - Record No. Page
I� any,-portion of,the,residential structure or ihe land, noi exceeding one (1) acre ihat immediately surrounds thai
structUie'is�u'se$- [o; p p e income, describe the use and
AU���L=� portion of the property utilized to produce income
Any other counties in which individual ovdns or is buying real properiy:
'��eby certify the above statement is true, correci and complete.
S:rP¢1 ACdtess
County
Township
ana Zm Goce
Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or h2s a beneficial interest in ihe iaxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceedinG 1(one) acre immediately
surrounding residential improvemenis
Other Land
Toial Land
Resideniial Improvemenis
Dv�elliny
Garage
Total
Other Improvements
Tot��iprov2ments - Line (6) plus (7) equals (8)
i hereby certify the above is true. correct. and complete.
Signawrc oi Assesm�
True Cash
Value
(�l
(2)
(3)
(4)
(5)
(6)
(�)
(E)
- ACTION BY AUDITOR -
C��' �/ v / ���I � 7% '� —,
/;pp;o�:Cd:_
Assessed
Valuation
o�:,•
Homestead
Valuation
Date: —�? � � �� _