Homestead_Kleinschmidt •
WOE Ire' R:rvnl TREASURER FOAM TAIA
APrErsLo BY MATE IXMRDOEA-rT FNTS-Zom per ,lam BT THE UTTARr EWOF LOCAL GOVERNMrKT FINANCE IC H.I+-tI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple,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.Homestead fraud causes higher tax bills for all:therefore.
® HEA 1344-2019 requires taxpayer who receive the homestead standard deduction to verily that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county gwrrment to better monitor homestead
filings.This information will he kept cent:densial and can only be accessed by authorised county officials.The Department of
Local Government Finance pill use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Kleinschmidt, Allen/Amy
Water lower Hill
I IAUBSTAD'I'IN 47639
7228
Allen& Amy Kleinschmidt
738 W Aspen Dr State Parcel Number Legal Description
HAUBSTADT IN 47639-8241
�t�ta��t tt�a��rttt��t�t�tt�rr�trt�r�r�r t�r rr��ta��t�rr�rt11111 26-18-36-200-002.236-024 Water Tower Place 24
•
PART 2: TAXPAYER INFORMATION •
Owner I First Middle Last
1,4-AtiffJ l,�F I-{Wt✓SCOAAA;
•
Ig Address(number and street,city,state,and ZIP code) --— — - O Seme as property addi ; — -. ---- —
'* $ Lois- ,fZcttfg.. {-1-40351-4)61- SW L{3(It 39J
Spouse Last
First Middle I 1 La
n
Mailing Address(Number and str 4 city,state,and ZIP code) ( [ Same as property address r
736 Sr�� NS Pit) oRzug (-�-40''srm rte; T43
PART 3:CERTIFICATION
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
unlaw fully ckTaxeradp.'ubstantial financial penalties.
Owne w azure Date �/
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn Sd73 (R6 / a-03)
PreacribM by the Department ot Lxal Gmemment Finance
INSTRUCTIONS: See �avarse side lor (liig inshu�ctions.
FORM �� YEAR
HC10 �
r�'.`''_-�°'s.�.:.1 :.- �5.. °S �.45'.-S�,'�..�: � _Y�'.�—.,"+. AT :�.��c ._"._GERTIF.IGATION STA7EMENT:z � ��='� s -- _ '�h=c� ?"� 1 '�:- ..
� �e� �yfy�t the 1HLdey Ma �. 20
�
I(VJe) occupied as our principal place o sidence Ihe following described real property for which a Homab�ead p rege i he daimed:
❑ I(We) owned ❑ Are buying under contrect Q (�
� Have a benefidal interest in the enlity Nat is liable (or Ne property taxes on the property and that owns ihe pr�er� oQis`b�M��nder a contraU.
If buying on conUad, Fee Simple ownefs name
Remrders ofice where mnirad is recorded
Counry
Tamship
Ta�ing disUict (ciry, fown,
Rewrd number � Page
� y�{{� ^ p«n ��� I �e9 �a �4(��� � ^� I Is the P�PertY in quesUon:
1
�/ �G�i���it/ {..'� ❑ Real property ❑ Mobile Homo (IC 6f.1-7)
I( any portion o( Ihe residenUal sWCWra w the lantl not exceeding one (1) ave Ihat immediately sunounds Ihat sWqure is used lo produce inmme, desai6e the use antl porllon
of the proPe+N utilized to produce irrcome.
�� -/�- 03 lo 0�00 -GY�o�. 073 lo - d�7
Counly
I hereby cerliy the above statements are W e, wrred and complete.
Ad �s (n�il,�� �. ���C7XPcode) [,t a
/ �. ��; G, S l- .0
Land not exceeding 1(one) acre immediatety
surrounding residentlal improvements.
Ofher land
Tdal land (line 1 pfus line 2)
Dwelling
�Residenlial improvements or MnuaOy
0.ssessed Modle / ManufacWred Home Garage
Other improvements
Total improvements (line 4 through line 6)
TUaI value (line 3 plus line �
I hereby certify the above is W e, corred, and
complete.
Veri(ying action - Sig�Nre oflwdi�or
(�)
�z)
(3)
(4)
(5)
(6)
(�)
(8)
Signature of Assessor
County
� 7�
Date sgned
Date signeE
��R�i4� ,.�3� :`�r��s",_�su'-�-s,�,;��i'�: STANDARp,OEDUCTION ALI:OWANCE ti� �;;:>ziL�'al'zs'^ ,-�2� s - ��"ig�`,•�'.'�';_'�°:'' .u'�3' -'�`
20_Pay20_
le,ser of 1/2 Homestead
vauanon w 535.000
S
Signature of Audflor " Date signetl