Homestead_Pohl (11) •
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APPROVED DY,Tilt&NW OFACCAU]T,.3+n PAfYRILQI BY TIE DEPARTMEr(i LOCAL CAIrouar AT rnM10EK'ia.I.S-AI
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 ever for homestead fraud.Homestead fraud causes higher lac bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe the
benefit and to provide additional identifying information necessary to allow county government ro better monitor homestead
filings.'lids information will he Lela confidential and ran only be acres-ed by authorized county officials.The Department of
Local Goverment Finance will use this information to create tools that will help musty officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Pohl, Steven S/Gayle R
R I Box 365 B (`�,
Ilaubstadt IN 47639Q
9437
Steven S/Gayle R Pohl
10770 S 200 W State Parcel Number Legal Description
HaubstadtIN 47639-8750
II iullnrlrlinullr1r1u 1u IIInrIrIrIr��urinrlliuulu�� 26-22-02-300-000.787-024 004-00787-00EW2-4-11279 AC
X
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
.fig Address(number and street.city,state,and ZIP code) 0'Some as property address
/0 720 5 200 L✓
Spouse First Middle Last
Grey/e � /21 /
Mailing Address(Number and street,city,state.and ZIP code) IW I Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
• .
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
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Si flue p Date
•
�j���`���" - CLAIM FOR HOMESTEAD PROPERTY TAX
�\ j CREDIT/STANDARD DEDUCTION
��i State Fotm 5473 (R2 / S92)
:%e'
1 6
INSTRUCTIONS: See reverse side (or filing instructions.
FORM
HC10
YEAR
�� TIFICA ON STATEMENT _
I(We) � certity that on the 1 st day of arc , _
I(We) occupied as our principal place of re � ce the to lowing descnbed real property for which a Homestead Prope�'�c �e9it i�{�qfgby claimed:
J 1.7y,y
❑ I(We) owned ❑ Are buying u er contract
❑ Have a beneficial interest in the entity that is liable for the property taues on the property and that owns ihe o erty o is b in der a ntr
GIBS
CONTRACTRECORDED - '
It buying on convact, Fee Simple ownets name
Recordefs office where contract is recortletl - . Record number Page
PROPERTY DESCR N
Coun � Tovmship Ta�ci dis ct (ciry �own, lownship)
Parce numDer— ^ _ � Legal deuriptlon ` —
( � .
It any ponion of the resitlential struct re or ihe lantl not exceetling one (1) acre that immediate surrounds t t swcture is used ro protluce i come, tlescribe Ne use and portion of
ihe property utilizetl to produce income.
�� -� - Oo? - a30o - 000. �2% D� �`
� PROPERTY OWNED BV CLAIMANT IN OTHER COUNTRIES
County Township Counry Tovmship
Signat of daimant
ereby ceAify the above statements are true, cortect and complete. �
Atldress (numbe� and street, ciry, sfate, ZIP cotle) .
x� 6s-3 N y 6
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VAIUE VALUE VALUE
Land not exceeding 1(one) acre immediately �� � -
surrounding residential improvemenis.
Other land (2)
Total land (line 7 plus line 2) (3) -
Dwelling (4)
Residential improvemenis
Garage (5)
Other improvements � (6)
Total improvements (line 4 through line 6J (7)
Total value (line 3 plus line 7) (8)
I hereby Certify the above is true. Correc�, and Signature oi Assesor Date signetl
complete.
Verifying aciion - SignaNre of Autliror Da[e signed
� STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead �
Valuation or 52,000
Sgnature af Audita Date signed