Homestead_Pohl (13) Slim ffRM'i'`.ta-r)-^1 TREASURER fn0.Yillt
AMMO'EnaY CITE IniRDeW MVVR:STS,Min ERr3Rnim BY ME DE?aaneJT OF DORM rsayst`1Mrt'r FINANCE wL,t-r- I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
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 e`er for homestead baud.homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpa)en who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to ptos'ide additional identifying information necessary to allow county goverment to better monitor homestead
filings.'Has information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance'ill use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY L\FORMATION
Taxpayer Name Property Address
_ Pohl, Chris A/Patricia M
I (j CJ, V) 9755
3064 Tj
Chris A Pohl
188 W 975 S State Parcel Number Legal Description
HAUSSTADT IN 47639-7805
I r1rt 11rt r1i11trtt11r1r1rrIttrIlttltllrr rtlt�r�t rlt�rr1rr1r1r1 26-19-31-202-002.128-024 004-02128-00 PT NE NE 31-3-101Ac
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
licis
i ,9�/
�tg Address(number and street,city,state,and ZIP code) ,�// / Same as property address
/ drg let/ ? i5 s /7o ubsloft fir '/1 6 9
/
Spouse Firs Middle Last
hfitic.; C1 n 600h /
Mailing Address(Number and street city,state,and ZIP code) 2 Same as property address
In w 975-c Po ubstd i- /V 99632
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 PROPERTY TAX
s CREDIT/STANDARD DEDUCTION
� State Fortn 5473 (R614-03)
� �� Prescribed by Ne DepartrneM of Local Govemment Finance
� INSTRUCTIONS: See reverse side fnc,�iling instrvctions.
J y FORM
� HC10
YEAR
i(we) �_� / Lx�u �'t' v_j,�� / l'1 �`-'� ertify that ort4he tst�fa f A�u�
,I�(W,�e) occupied as our prindpel piace of residence Ne following described real property tor which a Homestead Property T�c Credit is hereby, ai
✓f I(We) ovmed ❑ Are buying under conireci MAY 6 2�QS
,Have a benefidal interest in the enUry that is liable for the property taxes on the property and ihat owns the property or is buying under a conVaa.
If buying on conVap, Fee Simple owners neme
Recordels otfice where convaq is recarded
Coumy
Tavnship
Lepai description
Is Na
number �Page
V QC ��7L(�— V y+ � ' �jiteal proparry I_I Moblle Home (I.Q G1J-�
ol the residentlal sWCWre or the IarW rat axceeding ona (7 ) acre Nat immadiatey surtounds ihat sW cture is used to produca Income, describe the use and portion
y uNizad W pioduce incrnne.
� i v�
I hereby certify the above statements are W e, cortecl and complete. Signature rta daimant
� ']fl R1L1
�ess (pkmber arrd sLeef, ciry, atata, ZIP code)
20_Pay20_
Lesser of 1/2 Hanestead
Valuation w $35,000
�
S