Homestead_Elpers (24) SIAWF.FORM!Mt.IP_/HMI TRFALIRIX FORM it IA(
APPMwEDDY STATE M5RD M'MYl*NTR!1/M PRE9lNa0)BY TIr OFPARTME!T(4 LOCAL GOVERNMENT nrawrr I.1-r4I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sandanl deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud-Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2919 requires taxpayers who recent the homestead standard deduction to verify that they are eligible to recent the+
benefit and to provide additional identifying informatmn necessary to allow county government to better monitor homestead
�A \�`\` filings.This information will be kepi confidential and can only be accessed by authorized county officials.The I)epanntent of
I, p,�( Local Government Finance will usc this inform Lion to create tools that will help county officials eliminate homestead fraud.
fU.S',V/j� PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Elpers, Michael/Jane L,/3-00E /0505
ita t IN 4
Haubstadt N 477
(339
1695
Michael/Jane Elpers
4500E 1050 S State Parcel Number Legal Description
Haubstadt IN 47639-7848
I1IilIInlIlIIu 1111111111 IIuIuIIlIIlIIIIInlIIuuIuII D-10
27aooSE SE 35310 40 AC
� LP— / q 35-Ai Oo- ao . y63. as f
PART 2:TAXPAYER INFORMATION
Owne First Middle Last
_ lIe- '? l / S e/p (,_ Clive 4 5
ng AEdre.s @Umbel'anlLstrect;city,state,and ZIP code) / Same as property address' '— ' - . "' -
9S` C. C /0 50 5 14/4-r. to 5
Spouse First Middle _ Last
Mailing Address(Number and street,city,state,and ZIP code) [r{Same as properly address
1/500 c. /osoS flea br/4d I J°c
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.
72 / ' n Dnte
I
_,I .: •1 n•�
rt.
} CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
j State Form 5473 (RB / 1-03)
Prescribed by Ue Departmenl of Local Govemment Finance
INSTRUCTIONS: See ieverse side /or liling insfnicfions.
FORM
HC10
-- v
YEAR
� M'e) certify Ihat tb 1 st day p1vp1ar�ch, 20
I(VJe) occupied as our principal place of reside the following describe real property for which a Homestead Prope� Cie�t i�kf�by daimed:
❑ I(We) owned ❑ Are buying under contract �/�` l�1�� �
�Have a benefidal interest in the enti that is liable for the ro e taxes on the ro e '' , "' n
ty p p rty p p rty and that owns the,property oCis�buying�undecarCrnlract.
If buying on conVad, Fee Simple ownefs name
Recoidef5.afice where conVaa is recorCed
Record num6er I Page
County Tamship Tating tlislrict (ciry, rown, township) „-// �
rQU
P u r Le escri i n Is ihe property in quesGon:
�3 � ❑ Real pmperry Mobile Homo (I.C. 67J-n -
H any portim of ihe residential sW cture w the land not exceeding one (1 � acre ihat immediatety surrounds that swcture is o produce income. describe the use antl ponion
ot fhe propeAy utilizetl to produce incame. � Q•�� �
County
-.� �- v�-
�- �=`''�°a�'-.�,��PROP.ER'
Tavnship
I hereby certify the above statements are We, corred and complete.
��reEs (number�street, city, state, ZlPCOde) , � _ n
_ oa
County
Signature ofclaimant
�
�����'�� �i"r��'���.�`*.'":&r�'�'STAN�ARD;UEDUCTION'AL'L01NAtJCE �l�"'�s�' ;r���'.';;�.''�-'-,-���s�''`�`°�ze'�-�'''�.�`?�''y`�'rx�.s�.
20_Pay20_
Lesser of 1Y2 Homesiead g
Va�uaLOn or E35.000
SgnaNre ofAuditw � Date signed