Homestead_SchurmeierFDRM HC 1D 1979 To Be Filed in Duplicate
Prescribed By State Board of Tae Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR
C 192
SEE BACK FOR FILING INSTRUCTIONS
'We) OQ
- 0 n tk certify
that on the 1st day of
arch, 19-7—�-- I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We))il owned
❑ are buying under contract
❑ have a beneficial interest n the taxpayer
Property Description in . .z 9-2r- County 5 Township
Taxing District (16ity- Tewrr,. Township):
Parcel Number or legal description shown on tax statement:
Pf. SA 17-.-7-9 6o
If buying on contract: Owners na
Contract recorded in Recorders Office - Record No. Page
If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that
structure is used to produce income, describe the use and portion of the property utilized to produce income
Any other counties in which individual owns or is buying real property: County Township
hereby certify the above statement is true, correct and complete.
City. State and Zip Code
Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer-
- FOR ASSESSOR'S USE ONLY -
FILED True Cash
Value
Land not exceeding 1 (one) acre immediatelyU
surrounding residential improvements JJ
Other Land
Total Land
Residential Improvements
Other Improvements
N 41979 (1) Soo
(2) 1016-90
AUDITOR (3) / 3 � O
Dwelling (4)
Garage
Total
provements - Line (6) plus (7) equals (8)
certify thg gbove is true. correct, and complete.
of Assessor
(5) 3 4o
(6) 7 & a o
(7) 7 /ao
(8) /V-7 i/ O
- ACTION BY AUDITOR_:
Assessed
Valuation
Date
Date: / 5Le
0
Homestead
Valuation
STATE FOAM,3N lR_I.'/n ttLASULER FORM 73-IA
APPROVED
IMPORTANT NOTICE TO GOVEINMFM FINANCE IC -a
ibson County Auditor
/101 N Main
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 es Cr for homestead fraud.Homestead fraud causes higher lax bills for all;therefore.
NIP HEA 1344-2009 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 he Lepl confidential and can only be accessed by authorized county officials.The Depanncnt of
Local Government Finance will tee this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name _,,:....m.: ss
Schurmeier Farms Inc
11975 Petersburg RD
Evansville IN 47711
2696 i
Schurmeier Farms Inc
7287 S 750 E State Parcel Number Legal Description
FORT BRANCH IN 47648-8609
I I I I I I I I I I I I I I I I I I I I I I 26-20-17-400-000.911-001 001-00911-00 PT S SE 17-3-960 AC
111 to t nt n u1 t 1 u n nl 1 1, 11 t 111 tr I D-8
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last 4,1444-4-0 adicki
r
g Address(number and street,city.state,and ZIP code) - __ — _ -- G-1 Same as prepeny — - —
`d .4 o-wxh 7.5 C a 7-ett G.%.hre—fici tn, r g 7 G S'
Spouse First Middle Last
Mailing Address(Number and street,city.state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
scs
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 Signature Date
•