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Homestead_SchwartzCLAIM FOR HOMESTEAD PROPERTY TAX CREDIT /STANDARD DEDUCTION ` ! State Fonn 5473 (8817 -07) Prescribed by the Department of Local Government Finance INSTRUCTIONS: See reverse side forming instructions. I (We) t certify lKat`o`n& 1 at diy of M rch, 20_ 1 (We) occupied as our pdndpal place of residence the following desc real property for which a Home BypLjLYr�hOereby daimed: (We) owned ❑ Are buying under contract lave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract. FORM YEAR HC 0 CONTRACT •-r . If buying on contract, Fee Simple owners name Recordefs of5ce where contract is recorded Record number Page Cconly, Township Taring district (city, town. township) -- me' umber _ _ opal descn'pUm \ I Is the property in question: Ile\ %l� 1/I 'CJMJ ❑ Real property ❑ Mobile Home (IC 61.1 -7) If any portion of the residential stricture or the land not exceeding one (1) acre that immediately surrounds that sMx W m is used to produce income, describe the use and portion of the property utilized to produce Income. cAdrT 3 1 q a- k (N ASSESSOR USE ONLY TRUETAXVALUE.! ASSE�S*EDVALUEI PROPERTY OWNED BY County Tavnship County Township 1 hereby certify the above statements are true, correct and complete. Si ` re aim s (num and street, city: state. and Z1P code) .Y579 .. 4e ,✓ 7 rA'- �/76G 0 (N ASSESSOR USE ONLY TRUETAXVALUE.! ASSE�S*EDVALUEI HOMESTEAD NON-RESIDENTIAL - Lesser of 12 44000 for 2008 Homestead Valuation Pay 2009 41.000 for 2011 pay 2012 AT100%OFTTV VALUE VALUE Land not exceeding 1 (one) acre immediately Dale s" ed ( N. day . y surrounding residential improvements. O Other land Trial land (line 1 plus roe 2) (3) Dwelling (4) Residential improvements or Annually - - Assessed Mobile I Manufactured Home Garage (5) _ Other improvements (6) TUal improvements (roe 4 through line 6) (7) Total value (line 3 plus Gyre 7) (8) 1 hereby certify the above is true, coned, ant Signature of Assessor Date signed (month, day, year) complete. Verifying action - Sgnature of Auditor Date signed (month, day. year) . r DEDUCTION ALLOWANCE; = pay 20 _ 45 000 for 2007 pay 2008 42,000 for 2010 pay 2011 Lesser of 12 44000 for 2008 Homestead Valuation Pay 2009 41.000 for 2011 pay 2012 $ or 43,DW for 2009 pay 2010 40,000 payable after 2012 Signature of Atdiltur Dale s" ed ( N. day . y O mmAu otsi 1R:/w'1 TPOAStItEAFORV}IA .ArrrcwED BYSIVE MARDM'.MTvn INTL Y,s PtLw'RIBED BY nIE DEPARTMENT(if LOCAL OM'tRNMnf ra:ANCEM•,LI:]-r.1 Gibson County Auditor a 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 e'er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore. • HEA 1344-2109 requires taxpayers who receive the homestead standard deduction to verity that they are eligible to receive the benefit and to provide additional identif iln_ information necessary to allow county government to better monitor homestead filing.Ibis information will be kern 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. PART 1:PROPERTY INFORMATION Taxpayer Name Property Address Schwartz, Michael Bryan/Dana L 4579 S SR 57 Oakland City IN 47660 3194 Michael B Schwartz 4579 S SR 57 State Parcel Number Legal Description OAKLAND CITY IN 47660 26-20-02-201-000.976-001 001-00976-00 FREDONIA ACRES TRACT 3/PT4 2$9 2.56 AC - 56A —__ — -- This form MUST be returned to County Auditor's office. Please do NOT send this form back with your tax payment to the county treasurer. PART 2:TAXPAYER INFORMATION Owner 1 First Middle Last 1^rl�clnae ■ �rc�(� Schwari ongg Address(number and street.city,state,and ZIP code) R'$ame as property address Spouse First Middle Last 1�CZ Yl L 5cii W a Ir f Z Mailing Address(Number and street,city,stale,and ZIP code) ( 'Same 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. Owner I Si aturee Date • •