Homestead_Burger MATE FreRmnNntR:/tW+t MAULER FORM 11.1A
.ArramEn By soar.arMROnf MRILTS. n a n snuem 9r nit DErMTW.YT OF LOI'AI ombrY trier FN..tither-m-r•+•
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS I h
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 ester 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 teethe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kepi confidential and can only be accessed by authorized county ofcials.'ffie 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
Burger, Eugene G/ Bernie R
R2 Box III
Haubstadt IN 47639
1856
Eugene G/Bernie R Burger
1180 E Warrenton Rd State Parcel Number Legal Description
Haubstadt IN 47639-7937
I t1u11ur1n 1lnnlltitinlntlltlunlitlnrilnitlltt tlrtt ll 26-23-17-200-000.188-024 004-00188-00 PT W NE 174101.2029 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle ^ Last
Ct et/ G dryer
�w Addicts Amber and street,eity stain,and'LIP Cede]- - - — - — -- 'Same av prupertyuddress'-- ---' '--
Spouse First Middle Last
Vernie {Jai-ye ►r
Mailing Address(Number and street.city,state,and ZIP code) 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.
Owner I Signature Date
fit
Wfthl HC 10 19i9
Prestri�ed By Slaie Baartl ol ia. Cammissianers
CLAIM FOR HOMESTEAU PROPERTY TAX CREDIT FOR YEAR 19�
7o Be FileO in Duplicate
SEE BACK FOR FILING INSTRUCTIONS
� . �� � � 88��'�''Da
�We) ' �� —��+�>--�-•c- °� � �- ' certify that on the 1st day of
�arch, 19�, (We) occups�tl as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed: �
I, (We) ❑ owned �CO -�l �- �/�OIU� ��6d. ��6 '�Q
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in �<�-+-� Counry �i Township
Taxing District (Git�y, Tewn, Township): �+�+-+-�-s-�-�
Parcel Number � � � � � � or legal description shown on tax statement:
P�: ui � �YE y i�- y- io , d'o��,
If buying on contract: Owners name �'� �""o1e °^"ef�
Contract recorded in Recorders Office - Record No. Page
If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that
structure is used to produce income, describe the use and portion of the property utilized to produce'income
Any other counties in which individual owns or is buying real property:
certify the above statement is true, correct and complete.
Aaaress
County Township
Gry. Sa�e ana Zip CoOe
��i l either owns or is buying under a contract that provides he is to pay the property taxes
L��h idence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
MAY 2 � i979
Land not exCet�ag X i�w�.lZ�ediately
surrounding r�g{dential impU��p�n
Other Land
Total Land
Residential Improvements
Other Improvements
Dwelling
Garage
Total
To � Improvements - Line (6) plus (7) equals (8)
l�;�y certiAy the above is true. correct. and complete.
I���
True Cash
Value
(1) ,j� o 0
(�)
(3)
(4) —J��
(5)
(s> —/ A9�o
(�) —
�s� /A9ao
Assessed
Valuation
/ '7 0
Homestead
Valuation
�_�-s—
` � :��"�
� 02 /- 7 }'
oare "
Date: � �'� � ��