Homestead_Birchler n
STATE FORM M IR_IYrvl TREASURER CORN 11-IA
VPROYEB BY MATE&SIPDnr M IAA'NTS.FINN PUNTA:BFD BY MT.OEPARTLLYT OF LOCAL Cie ERiMENT FINANCE II' I.•2]41.1
Gibson County Auditor
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.I lonmtead fraud causes higher tax bills for all:therefore.
HEA 1341-2009 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 kept conlidential and can only bat accessed by auihnri,ed courtly officials.The ocpanntent of
Local Government Finance will use this information to create t'ols that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Birchler, Jerry L/Bobbie J ((��
RI Box 478
Fort Branch IN 47648
7198
Jerry L Birchler
9874 S 250 W State Parcel Number Lela! Description
FORT BRANCH IN 47648
26-18-35-100-001.091-024 004-01091-00 NW SW NW 35 3 11 10 AC
D-27
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
L e B Qc 1. Ls-2
•Fg Address(number and street,city,state,and ZIP code) - 1 ---r- I�nme is property address -- - _-
97 � / s r asap. FT 3QAJG� J i '17 1 8
/
Spouse First Middle Last
606131E �LS�3 + 312c+a1 rL
Mailing Address(Number and street,city,state,and ZIP code) ‘me as property address
97Y95 , 93t3 YT`(� 2.>3aJCk1 , Zn1 , tTh i
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.
Signature Date
•
•
e+ rt�� ; CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
'� f State Fortn 5473 (RS / 10-01 �
Prescri6ed 6y the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side !or liling instruc(ions.
' R =�} ""�1 ,' . , � - �� � �-. n R�RTIFICAT
3 :.
FORM YEAR _i
� �iC10
AU G 12 2002
� � - !i � �� _ n
�(N�e) i��,� "vLKXJ �• c i a �d3y'Ui�r ,'�0_
�
1(Wej occupied our pnncipa of residence the following desuibed reat property for which a Homest adaP,t@�Hd���Credit�is ereby daimed
� I(VJe) owned ❑ uying under wntract
`Have a benefidal interest in lhe entiry that is liable for the pmperty tazes on the property and Ihat owns the pwperty or is buying under a contract.
;�: �c . .��r,�'d= . � _ ��;, �, �..._`' .. � J.:�`:''.,1::.. CONTRACTRECORDED t_: . � - ,: . ;-,- . ., - . _
If buying on contrad, Fee Simplo ownefs name
Remrders office where wnUaU is recorded Rewrd number Page
,. x �� l_a.. �.-. � - : ,:' ." - .7. �'c ''t'^y, c-: .
_. -PROPERTYDESCRIPTION;� � - �--.r-�._•.�.
Toxnship T�ing dislritt (ciry, tow , town
P e�t.//.�� � e cn io the pmperty i uestion:
�� \//�/ � I � �S� � � Real proPeRy ❑ Mobile Homo (I.C. G7.7�7)
L
i( any ponion of Ihe residential structure w the tand not exceetling one (7) aae �hat immetliateF//.,^.Spqyl�that sWUUre is used co O��uce income. describe the use and portion
of Ihe property utilized to produce inwme. /�.J/ ��—
c�� -/�-3s-/�-o0/.04/-Da �
" "" ���'�"'�" '"-` � �- � � � �TRUE-TAX � �ASSESSEDVALUE �HOMESTEAD� � +� y^�--'
t���4 iASSES50RUSEONLY � f - r ��.' �qT100%OFTN .;`VALUE4ss �,ti�'�{''.N.�N. VALUEN�IAL�i„�
�f..� r�,�..i� _ �."� .a �. . ,'' i: VALUE�
Land not exceeding 1(one) acre immed�atety � `�� +-' z�' �� r;- i
sunounding residen6al improvemenLS. (�) `,.' :� Y �` n =
O�herland (p) =°`�;i°��>�-�:* - -- -
: e
Tdal land (line 7 plus line 2) (3)
� � : ,
Dwelling (4) `a a t''"`'� � � -?b3' �w:+,
Residentialimprovemenls ' ��tfii �r' ���'y'��-�
� - 'y.i� A �,�T�. F.
Garage (5) �' �o- �c °`� vY�� �, 3srs.:
- �-�'i.?±'_:'L:-.�_r..,�.`F':Sg.._..-.,
Oiherimprovements (6) �v� �� =1tr�'
,;,' �:`� _�; ., -.-.,
Tdal improvements (line 4 through line 6) (7)
Tdal value (line 3 pl�s line n (g�
I hereby cert"rfy the above is We, conecl, and Sgnature oi.�ssessor oate signed
complete.
Vui(ying actbn - Signature oflwtlitor _ Daie signed
20_Pay20_
Lesser of 1/2 Homestead
Vajqa6on or 56,000
S
Date