Homestead_Elpers (34) 51.0E FORM!'5 IR /swt IREArallliOnv YIA
.APPROVED BY Stiff BIRO M 6rrousn2n, PRL%BIBT BY TIT DEPAMTQ=YT OF LOCAL COVELNMINT FQ:AYYE to
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and harried couples are limited to one homestead standard deduction.As the receipt of this deduction became;
more beneficial.there is more incentive than eser for homestead fraud.Homestead fraud causes higher tar bills for all:therefore.
H!A 1333-2009 requims taxpacers who receive the homestead standard deduction to verify that they are eligible to recent 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 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
Elpers, Jerome T/Glenda
R2 Box 5313 oi(___--
Haubstadt IN 47634
3390
Jerome T/Glenda Elpers
5024 E SR 68 State Parcel Number Legal Description
Haubstadt IN 47639
26-23-01-400-000.270-024 004-00270-00 PT W E 1 4 10 1.545 AC
D-10
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.
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
"3-er6 T E ers
SIT Address(number and street.city,state,and ZIP code) Same as property address
__ E. S \ s(98 t3'9c &a-* sty 4C1■ 3c(
SS ue First Middle Last
G1e1.e,k S . Elrers
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
569 A E, tag Ekct,„ s-\ * cz \ 4 b3e{
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.
0
wxn+ nc io �wv
PreuriCM By State 80d1E 0� Tdl COIIIRIISSIOf1U5
To & FIeG in Dupli�ate
CLAIM FOR HOMESTEAD PROPERTY TAX CREOIT.FOR YEAH 19��
SEE BACK FOR FILING INSTRUCTIONS
���We) ���'�� ��4�4 GL, °� �i certify that on the 1st day of
� arch, 19 I, ( e) cupied as our principal place of residence the tollowing described real property for
which a Homestead Property Tax Credit is hereby �being claimed:
I, (We) L�f owned
�are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description i
Taxing District f6ii�r- Tewn, Township):
Parcel Number
If buying on contract: Owners
�d� 6�a��-oo �/
�� - � -o/- �D -�D • �7U -da �`
nty Township
or legal description shown on tax statement
� /�J � � % l — S� — / O /, s 5�S de.u..�
Contract recorded in Recorders Office - Record
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: County
iere y certify the a
Q/,.avn2 �
'Signacure
statement is true, correct and complete.
�
naareu
Township
City. Stak ena 2io �e
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
.Y
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immediately
surrounding residential improvements
Other Land � � � �i �
Total Land g�
Residential Improvements Dwelling
� JUN ? 6 i979 -�
Garage
�i/, ���uJ2�a I
(/� 7'
Other Improvements ��T AUDITOR
To' ' Improvements - Line (6) plus (7) equals (8)
I�Sy cert�the above is true. correct. and complete.
Sgriatwe oi nssesmr
Approved
�
True Cash Assessed Homestead
Value Valuation Valuation
(t) _;`O O
(2) � 7 �
(3) 7 � a
ca) .70 5�3b
(5)
(6) Z O �3 p
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(g) �"�
- ACTION BY AUDITOR -
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Date: L