Homestead_Bengert STALE I11RM`)t IR'/,aryl 1RfASURFR FORMISIA
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Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
p PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
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more beneficial.there is more incentive than aver for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 13+1-3009 requires taxpayers who remise the homestead standard deduction to rerifv that they are eligible to acme the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings This infnrnution will he kept tont:dential and can only he 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 •
Bengert, Michael R/Doyna L
R2 Box 152 F
Ilaubstadt IN 47639
11029
Michael R/Doyna L Bengert
2158E Presley Lane State Parcel Number Legal Description
Haubstadt IN 47639-7967
26-23-16-200-001.835-024 004-01835-00 COUNTRY AYRE EST 18
Ithollettlelltrir11111111111.1111totiltriterldelplorloldrol
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PART 2:TAXPAYER INFORMATION
Owner I / First Q Middle ,/� Last
l� rWIGv� lg /Se/tgems" —
r !
Ow Address(number and street,city,state,and ZIP code) — - -- _ - - a Same nn property dress — —
a l SB C tog ESLe y 1,4tJC
Spouse First Middle Last
D✓otJ`//+ L IJcoaerir
Mailing Address(Number and street,city,state,and ZIP code) Same as properly 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.
Owner 1 Signature Date '
1
�E e
�e
:�'�'
_ � .
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2 / 592)
INSTRUCTIONS: See reverse side lor filing inst/uctions.
FORM YEAR
C 0 �
��
- C RTIFICATION STATEMENT
I(We) certi tha on 1 st da f ch, 19_
I(We) occupied as ou principal piace of residence the following described rea operty for which a H GIBSON N A by claimed:
❑ I(We) owned ❑ Are buying under contract
❑ Have a beneficial interest in the entity that is liable tor the property taxes on the property and that owns the properry or is buying under a contract.
CONTRACTRECORDED �
If buying on conVact, Fee Simple owners name
Recorders offire where conUact is recorded - Record number Page
PROPERTY DESCRIPTION �
Counry Township Tadng di nd (ci wn, ship)
Pa ce number Legal descnption •�
� 3S
It any portirn of ihe residen6al sWCNre or Ne Ia�W noi exceeding one (1) acre that immediat urtountls ih suucture is used to produce income, describe ihe use antl portion of
Ne property utiiized to produce income.
-�3 -/ - QO - DO/. ��S-
� PROPERTV OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Tovmship County � Township
Si nat re of daiman
,ereby certity the above statements are true, conect and complete.
(number and sfreet, ciry, state, ZIP wCeJ
!� Q Z gio � Y7�3
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
land not exceeding 1(one) acre immediately �� � �
surrounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvemen�s
Garage (5)
Oiher improvemenis (6)
Total improvemenis (line 4 through line 6) (7)
Total va�ue (line 3 plus line 7) (8)
I hereby Certify Ihe above is Irue, CorteCt, and Signature of Assesor Date signed
complete. �
Veritying action - Signawre of Autlitor Date signed
�; STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead y�
Valuation or $2,000
Signatu o uditor Date signed -
,�? - a -�