Homestead_Leible (3) ^ • STATE FORM 53Ma IR=/NMI IPFAsarn FORM 73-IA
.APPROVED Ily SISTE F 4RD(K nen/ANT(Y/n PRrAAInm BY fiE DEPARTNY_Y10F LOCAL cOTRNMFAT FINANCE II'VI.1-._-1.1
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 et or for homestead fraud.Homestead fraud causes higher lac bills for all:therefore.
III HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to recent the
benefit and to provide additional identifying information nee :531y to allow county government to better monitor homestead
tiling.This information will he DTA confidential and can only be at-missed 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.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Leible, Daniel K/Dorena K
7982 S Andee LN
FORT BRANCFI IN 47648
2975
Daniel K Leible
7982 S Andee Lane State Parcel Number Legal Description
FORT BRANCH IN 47648-1545
26-1919103001.192-026/SOUTHGATE6
Itlulintit lluJt,lluL lilitiullllllll 11111 lllllllilr
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 yy Middle Last
DANIEL 9��NT LE I et, I=
40 ng Address(number end street,city,state,and ZIP code) Same as property address
fiq a s . A-nck I: LaN) E__ T7 3� lac 4-� �. N W1 (9�
,
Spouse First Middle Last
toR uA KAY I,-EIguE
Mailing Address(Number and street,city,stale,and ZIP code) Same as property address
qq 5 , .�-�, 1)EtE L 3E BRA ►\_)cN i-N 9 1-0 (4 ?14
- - --- - -^'- _. -_
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 Signature Date
CLAIM FOR HOMESTEAD PROPERTY TAX �� FORM YEAR
� CREDIT/STANDARD DEDUCTION HCto
`- ' Stale Fortn 5673 (R8/7-07)
Rescnbed by Ihe Departrtierp of Loml Govemment Finance
/NS7RUCT/ONS: See raosrse side /orbli�g inshucHons.
/��j'��1 L 0 MA� 0 5�009
I(VJe)—� �l – �{ c/ y certi that on e 15t day of March, 20
I(We) oocuwetl'BS our prindpal place of residence the following described real property for which a Home tead Prope/r�ty Tac Credit is hereby daimed:
'I(We) owned ❑ Are buying under contraG �a� '°' �
� Have a benefidal interest in Ne entity that is IiaWe for the property taxes on the property and M16lflS�bi�.�AYrTy�'oPid6iiyid$ under a contract.
N bvying om m�ltaq, Fea Simple oariefa nama
Recordefs otuce whera wrrt2d is retordeu
Twrship
Is the
If airy ponian W ihe residet�ial svuaura w Ne WM not azceedirg one (t ) acre �hat unmediately surtounds Uml
of Ne ryoperty W Ezed b produce inwme.
Recdd number
❑ Mobile Fbme
Page
6/.
is used b ptoduce Inmme, desrsibe Ihe use ard pption
�_ � � � .� • �
�� . �
Land not ex�rg 1(one) a�re immediately r"� �
surroundingresidentialimprovements. ��� ;;�.:i;.c;?��;=�:::`<.s•�;�,i�'.0
Other land �p) -
Tdal Wnd (line 1 plus line 2) �g)
r
;:,t t �.:+. s.:., i � .
ResidenfialunprovementsorMnually Dwelling (4) ' '�rx� r �.,s = �� ef..
Assessed MoW7e / Manufac4ired Home
Garage �5� � �" '
�l-:C�..
�f�l@f IffIPfOVMf12f1�5 �6� '
Total improvements (line 4 fhiough Gne 6) �7�
Tttai value (line 3 plls line n �g�
I hereby certify the above is We, correct, and signature ofassessa pa�e sy�ed (n,or,tn, y�y, yeer)
complete.
Vaifyirg aclion - SignaWre oflwditnr Daie signed (�W, aaY• Y�/)
�U pay 20 _ qs�ppp for 2007 pay 2008 42.000 for 2010 pay 2011
Lesser of 12 aq,ppp for 2008
Homestead Valuation PaY Z009 41,000 for 2011 pay 2012 $
a ^ n 43,000 for 2009 pay 2010 40,000 payable after 2012