HomeMy WebLinkAboutHomestead_Adler (5) STATE FORM SJS6V(NI BID) TtF•a TER FOAMRIA
APPROVED BY SCVE BOARD OF ArcousTS.2009 PRF-ScmIBFD BY TEE DEPARTMENT OFtDCALGOVERNMENT MANE IC 61.13341t
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
a benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
I L E T filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
e,L\/ Local Government Finance will use this.information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
APR 5 2011 Taxpayer Name Location Address
Adler, Jeremy D/Robyn D -
— C" '� 2509 E CLASSIC DR
HAUBSTADT IN 47639"9536
GIBSON COUNTY AUDITOR
3093
Jeremy D/Robyn 0Adler 1111111_III 111111111111 viii:v1111111111111111II_111 81viii:IU ftf11111.iviiii iI
2509E Classic Or
Haubstadt IN 47639-7962
'IItPt llllill'i'It1tlllllllIlll'll'iilill'lll"tllllllllli"III State Parcel Number Legal Description
v — — — 26 23-16 400 001.847-024/RIDGE MANOR EST SEC 2 LOT 1
D9
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.
(` 1 PART 2: TAXPAYER INFORMATION •
Ch` ' First Middle Last
Ttrern y ' Da1e. Adler
Mailing Address(number and street,city,state,and ZIP code) ® Same as property address
25o, E Classic U, l-latcbsfadf, /A/ h/74039 ,
Spouse First Middle Last
Robyn I la
Da� n �el / e ' Adler
Mailing Address(Number and street,city,state:and ZIP code).-- - _" _ _- — — -- g t ,Same as property address - ----- -
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. �` -
� � CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Sule Farm 5473 (RB /4-03)
Presuibea by tAe Department of local Govemment Finance
INSTRUCTIONS: See reverse side lor �ling inslnrctions
FORM
HC10
YEAR
JL/
��Ne> ��N L5 LUU4
certify thal on' 1 st day of March, 20
// —il
I(We) occ p' as our principa p ce of residence the following d cnbed real property (or which a Homestead P rty Tac Cr it is ereb�
❑ I(We) owned ❑ M 'ng under wniract c�! QU� ���fTOR
, Have a benefidal interest in lhe entity that is liable for the property taxes on the propeAy and that owns the p�er�- s b�ying under a wntraU.
I( buying on conVact, Fee Simple owners name
Recorders ofice where conVaq is remrdetl
County
H any portion ol
ot Ihe praperty i
Tamship
de:
���oo
lential sWCWra w the IaM nW
� produce irimme.
� % '�{ � �/ — ^7
Tating district (ciry, town, township)
one (1) aae that immeCiatety wrrounds
�� �
Record number � Page
in question:
] Real ProPerty ❑ Mobile Homo O.Q bf.
swcWre Is used b produce income, de5aibe Na use and portbn
� � -,+F:a, '.Y"'t.�•= - --. .�-- _ . _ ..., ..-' -r--�- --'r- --- t..ztist� Z�v�,ryy.°.�, -' e --
�^_��' � :�_. :,:�'s�_�-.�a� �e�-�?a�-sPROP.ERTY,OWNED-;BYCL'AIMANTIN.OTHER�COUNTIES,Gi'.,x,y.,,:r,;.�,�„ft_re .�, �,�,..�yr.�-,�?ti,�.iO�.'�;
Caunly Twvnship County Tavnship
I hereby certify the above statemenls are W e, corted and complete. Signature ot Gaimant
AEdress (number aM stree(, ciry, sfate, ZIP code)
'`�z^���*=_��'.��r��z��?���ii5TAN0ARD:DEDUCTION'ALLOWANCE'��',i�pu+�a���n.^�:�������� �
20 _ Pay 20 _
Lesser ot 1/2 Homestead $
vauanon or E35.p0p
SgnaWre of Aud'AOr / I Date s" ed
W � � �