Homestead_Loheif
start FORM 5'4n MU NMI i1E tL[rA FORM:11A
ArrA'ED BS SIAM DRUID Or Nry it tATS, ParSCRInF)7nY TES DEPARTMENT Or LOCAL GOVEL4MIT7 La:A\CE R`VI.1-S_J.I
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 ever for homestead fraud.I Iomestead fraud causes higher tat bills for all:therefore.
IP HEA 1347-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to revere the
benefit and to provide additional identifying information nee-moan.to allow county government to better monitor homestead
tilintv..This information will he kepi ron€demial and can only be accessed by authorized county officials.The Department of
Local Government Finance alit me this information to create :cols that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Lohe, Kimberly J
209 W Vine
Fort Branch IN 47648
6855
Kimberly J Lohe
209 W Vine St State Parcel Number Legal Description
FORT BRANCH IN 47648-1035
Itlttllttt ltllttrittl1tt 1tt VIII' 11It 1t 1t11trt1t1t tut 11r1 26-18-13-404-000286-026/011-00288-00 SYMONDS ENLG 192
" PART 2:TAXPAYER 1NFOR\1ATION
Owner I First Middle 1 Last
tl m q --a�e
tg Address(number and street.tt y,state,and ZIP code) - - - '�{Sarne as property address — - — -
Spouse First Middle Last
Mailing Address(Number and street,city.state,and ZIP code) ' snie as property address
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.
Own:I Signal Date
e� rt��`t CLAIM FOR HOMESTEAD PROPERTY TAX FORM r YEAR
�,/� — I
� CREDIT/STANDARD DEDUCTION r��o � �
� � State Form 5473 (RS / 70-0t) "
Presvibed by the Departmenl oF Local Govemment Finance
INSTRUCTIONS: See reverse side for liling inslrvcfions.
Counry
Tavnship
Parcel number Legal descriplion
o��-�a��„-�
Tacing dislricl (cify, fown, township)
Is �he property in question:
❑ Real vroOeM ❑ hlobile Homo (I.C. 61.
I( any portion ot tha residenval sWClure w the land not excaeding one (1) aue lhat immediately sunounds that structure is used to produce income, describe Ne use an0 portion
o( tha property uWized to produce inwme.
' �"��"-'�'J '"`' y ' "`—` t ' `�� �3-'s. ' �"TRUE TAX > ASSESSED VALUE HOMESTEAD� - r hNON;RE5IDENTIAL'� � �
�z' �" �ASSESSOR(1SEONLY ��� c ,r. ��°� �� S �'e�+,�l .c_ , ra�i:
�� .�.�.� �:: �16�"u,� ?-�f�°.1'."���,.ti,''�...� i�. VALUE:; �. �AT-100Yo OF`TTV. . i,.: VALUE Y;.Fj ..r_.:?.�,VALUE�c.,t�t:�, '
Land nol exceeding 1(one) acre immediately ~ r` gYS'f` '`� -'' �� �;; � h��>
surrounding residential improvemenls. (� � =,��� ,y ?�y,�����F��' .;'3 �a,'�`,� i;,
'.<4 �Fi:* �:^�;JL:?:r�.�
Ofher land � ^. = ��?���` `�;
(Z) ?�2_ xr'<,�;,`n`'"
Total land (line 7 plus line 2) (3)
� � 9 -`s r ,._
Dwelling (4) 33��r�'�����13,`�..':`w'ai
Residenlial improvements �
�. � zB-:a-.e� .�:�r�
Garage (5) ,"-��'�ftra��.s��$�r:�waji�.�
:.. t�a �'�-`�^4 `' i•-r�'s'. �4j T� �
s �- -�'� � '� 1� �
Other improvements (6) � �„-� fs��'3�'�,a,'-
�si-.._J'.c.
Tctal improvements (line 4 through line 6) (�)
TUaI value (line 3 pl(s line n (g)
I hereby certrfy the above is We, corted, and Signamre o1 Assesmr Date sgnea
complete.
Verifying actbn - Si9nature oflw0itor Dale signed
_�
y�,�,� . _ T''�'.,�.^'.:._�i''��.��-+r.'� ��."G'�>f-%STANDARD:DEDUCTION��ALLOWANCE "�` ��. �ir.:.�a`3.-.s �L-''' z- � _�r�:��7;1!= :,.. �--�.
SM��vnC�-�-�,�. i'�'a � -,'�i� � �, r
' 20_Pay20_
Lesser o( 12 HomeStead
Valuation or 56,000 5
Signature oflwdifor Dale signed
� -w "'� � �