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Homestead_Moers MMAtt l ORSt tN I R r art TM-ASMUUR roaM T3'.A RwrIMPORTANT NOTICE TO HOMrESTEAD PROPERTY ROWNERS Ia-L'J.I • Gibson County Auditor 101 N Main PRINCETON IN 47670 IndividuaLs and married couples arc limited to one homestead sandanl deduction.As the receipt of this deduction becomes S more beneficial,there is more incentive than es er for homestead fraud.Homestead fraud causes higher tae bills for all:therefore. HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the benefit and m provide additional idemifyine Information necessary to allow county government to better monitor homestead tiling.This information will he kepi contidemial and can only Iv accessed by authnri,ed county officials.The Department of Local Government Finance will at this information to create tools that will help county officials eliminate homestead thud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Moers, William E/Gail L \L R_ FORT BRANCH IN 47618 11009 /6`S E /zoo s. /14u sraD, Cr' °/7435 -1d/7 William E Moers 1665E 1200 S State Parcel Number Legal Description HAUBSTADT IN 47639-8047 It lttllrlt ltlltttt11t1t 1tt 1tr1t11t tt t1tt11trtltllttt irirt trill 26-23-16-100-002.010-024 004-02010-00 PT NW NW 164107.047 AC ^/ D-9 PART 2:TAXPAYER INFORMATION Owner I First Middle Last IN LL Rr- EdwA2p P9oE2s �ig Address(number and street.city,state,and ZIP code)- - - --— _-._-as property address -- -- -" — /E6s- F / 0o S, HA0asrnpr/ a-rz 517g3r - goy-? Spouse First Middle Last GAi L Gg,Vrs. Thy ERr Mailing Address(Number and street,city,state,and ZIP code) lat<me as property address 1661 C. 1200 S, 14A0BfrDA1-jr'.-' 5/7427- 1077 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 • CLAIM FOR HOMESTEAD PRQPERTY TAX CREDIT/STANDARD DEDUCTION State Farm 5473 (R614-03) Rasaibed M tlie Depenmeiri d Loril Govemment Finance wsrnucnoNS: s� ��a. mao w� �m�md,c � '�OR YEAR � �� -� JUL 2 2 2005 � (We) � L L. ce�i(ffi�l9lP6lD�p3t�eay�6FA�5}@i. 20_ I(We) occupied our principal pl of residence fhe (ollowing described real properry for which a Homestead Property Tac Credit is hereby daimed: �I (VJe) owned ❑ Ne buying under contract Have a benefidal interest in Ne entity Nat is liable for the property taxes on Ihe propeRy and Nat owns lhe property or is buying under a conVaU. If buy'ug om m�iraq. Fee Simple owners name conirad is remrded Counry Parcel nu 6er Qp��b; I( any ponion af Ne resiE of the property util¢eC to 7axnship Lagal descriptian rict (riry, town, �sa—F Is the property sWdure w Ue land not exceeding ona (7) aQe that immetliatety wrtounds that ce iricome. �%�Li Record number � Page Question: �aal property ❑ MoWle Homo (/.C. 67.7-7) re is used to Droduce income. Aescribe Me use and portion �`�'5�.�-��-'�'�-��,r�. -.m`-'"h.����PROP.ERTY,:OWNED:�BY.CLAIMANT,IN;OTFiER'COUNTIES},`'�"'.�+`�5�.��;:�r`��'�^`�"�'r,"�`',--�'.�','��`�'""g County Toxnship County Twvnship I hereby certify ihe above statements are We, corred and complete. Signature ot daimant 1��_�� �'� � i'�O"'... �dress numberaM streef, city state, ZlPcode) R 1 l�oxlos✓ cRr�oo S �`�� �����' £'' `��'`{'''�� ��TRUETAX��k ASSESSED VALUE ;�HOMESTEAD'��` � NON-RESIDENTIAL h .,��t�s�_'�'��`��fASSESSOR�l1SEONLY-`.�--� �!�r yp�;UE�;�sb� �`AT100%'OFTTV VALUE �_f`y','a-..VAI.UEry,� ,r,�s �.+�'E,T.��.a�'#rsf#����,.�A. �-�?a �t7.a.v. . .� � ...,. >.,d,...� �.�..- .. ,..� �� ��i�? Land not exceeding 1(one) aae immedialety � r'"„� s-;, '�""',-�,n.-�� ��' ��"�'�.f..rA,. surrounding residentlal improvemenis. (�� ��, .,,.'.;"'`f,���rt,t,�` �f' �� _� � ,, -_ �: "'"'�"'z` Other land (y) �:'�,-����� ..sa,� >;r`: Total land (line 1 plus line 2) (g� . ��+.��- .� .. ��%: Dwelling (4) � � �,��, � ���ur��� �Residential improvements or MnuaOy Asauxd AbhOe / Manufa�red Hvne Ga2ge (5) '��������;�3 _ v� ��-M 3�.,: � ..2s'��,'ni�.,�e� —� n ' Other improvements (6) �Y�� 3i����Y a-r:w°.'Fi :'„n�+''�.� Tdal improvemenfs (line 4 through line 6) (7) TUaI value (line 3 ptrs line n �g) I hereby certify ihe above is We, corred, and Signamra o�nsseswr oate signed complete. Verilyirg action - Sigriatura ofluidibr Date signed �