Homestead_Schutte (3) •
•
STATE FORM 51569(Pi 0.10) TREASURER IDEARIA
APPROVED BY STATE BOARD OF ACCOUNTS.MN FRESCRWED BY THE DE/ARMEYT OF IM.U.GOSTRNMEsti FC'ANCE k'6-t.1-234.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
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 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.
PART I: PROPERTY INFORMATION
T� Taxpayer Name Location Address
IL^,'1
1 En Schulte, Mark A
MAMAYq p 7997 S ANDEE LN
2 p 2011 FT BRANCH IN 47648
2589 Mark ASchu C.3. IIIII1111�11111111 III1111811111111111111111=111111011:11 11111111111.1111111111
7997 S Andee La��N COUNTY AUDITOR
FORT BRANCH IN 47648-1548
IIII'llllllllllltllrIII'Illltlltttllltlttlll'll�'lll'ililll'lllll State Parcel Number Legal Description
26-19-19-103-001.187-026✓SOUTHGATE1
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.
r- PART 2:TAXPAYER INFORMATION
`T First Middle • Last
/1(&14L cif �t�e_.
Mailing Address(number and street.city,state,and ZIP code) Dame as property address
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) LJ Other(please specify in Part 4 below)
1 1 1 1 1 1 1 1 1 Sore
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,Siignature Date
° CLAIM FOR HOMESTEAD PROPERTY TAX FoRM YEAR
r. •- : t CREDIT/STANDARD DEDUCTION HC10
s�� Fo�„ sa�a �Ra r �-o»
•� 1 Prescribed by Ihe Oepartmerrt o( Loral Govemmeni Finarroe
INSTRUCTIONS: See reverse side lor filing insLuctions.
i(We) � V��� �� certiiy that on tr� p,s[ d� � eear�r4 2b
1(We) occupied as our prindpal place o residence the tdlowing described real property tor which a Homestead Pmperty Tac Credit is hereby daimed:
/� 1(VJe) owned ❑ Ne buying under conUacf � ,Q
Have a benefidal 7nterest in ihe entiy Ihat is liable fa the property faxes on the property and that owns ihe prop��O��tLu�e����t.
If buying om m�trac4 Fee Simple wmers name
Recorders office where
Counry
TavnsNp
If any poNOn of lhe residen6al sVUCture w ihe land
ot the Properry uUtized to pmduce inmme.
� /U.7 —
Rewrd number � Page
Tacing distnq (city, town,
,, I I Is Ihe property in question:
J(A' A�N �. ❑ Real ProPartY ❑ Mabile Home (fC 61. 7-n
one (1) acr that immediately surtounds that sUUCture is used tn produce inmme, descnbe Ihe use and portbn
•�• � �: • �
Counry Tavnship County Toanship
I hereby certify the above slatements are true, correct and complete. SignaWre of daim
�
ess(numbe�arrdsheei.cRy.stat a ZlPcod) � �
[�
�_ � � � .� • �
�i'. •
Land not ex�rg 1(one) aae immediatey �1) �:'.� i �'z� �::
surtounding residential improvements.
Other Wnd (p� - - --
Tdal land (line 1 plus line 2) (g�
Dwelling (q) ��� � _ _ *• �,.
ResidentialimprovementsorMnually ` �`�� �• z5„-.�.-'-.'••: �
Assessed Mohiie I ManufacWred Hwne '-
Ga2ge �5)
Other improvements (6) , � ' .
TUaI imprwements Qrne d through line 6) (7�
Total value (line 3 pf's fine n �g�
I hereby certify Ne above i5 We, cqrtett, and Sgnatma of Pssessa Date sgned (monN, day, yea�
wmplete.
Veilyirg action - SignaWre ol Autlitw Date signed (monN, tlay. yea�
<� pay 20 _ 45,000 for 2007 pay 2008 42,OD0 for 2010 pay 2017
Lesser ot 12 qq.000 for 2008 pay 2009 41.000 for 2071 pay 207 2
Homestead ValuaCon S
« 43,000 for 2009 pay 2010 40,000 payable after 2072 ���