Homestead_Regener (3) .Si&TE IORN!!.'IW IR2/54PI TWASIIrfR FORM:StA
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Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS _
101 N Main T.
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 net for homestead fraud Homestead fraud causes higher In bills for all:therefore.
® HEA 1344-21109 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.Ibis information will be kept confidential and can only he accessed by authorized comity officials.The Department of
Local Government Finance will use this information to create totals that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Regener, Norma A Trust
1172 E Warrenton Rd
tlaubstadt IN 47639
11084
Norma A Regener-Trust
1172E Warrenton Rd State Parcel Number Legal Description
Haubstadt IN 47639-7937
lulrrilturiulIrrrrliritlrulturl1t1turu11u1rru11ur u1rr1t1r11rr1 26-23-17-200-000.801-024 004-00801-00 PT W NE 174104.9934 AC
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
ivo k/v A g G CA✓C,C-
//g Address(number and street,city,state,and ZIP code) Same ss property address --
7a2 G, istinkirniTON, Q1 Aobsmsr IN, `'763y
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Drivers License/Slate ID Number (last 5 digits) - • Other(please specify in Pan 4 below)
sue
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 lia back taxes and substantial financial penalties.
Owner 1 Signature Untc
• •
wwn xc m is�s �
Prexri6eE By State BoarE af Tax Commissianers
To & FiIM in Duplicate
CLAIM FOR HOMESTEAO PROPERTY TAX CREDIT FOR YEAR 19Z2
SEE BACK FOR FILING INSTRUCTIONS
�(We) a-'-�'� ��` certify that on the 1st day of
arch, 19 I, (W ) occupied as our principal place of residence the following described real property for
which a Hom tead Property Tax Credit is hereby being claimed:
I, (We) �d D� �� D��� j� d�
❑ are buying under contract
❑ have a beneficial interes), in the taxpayer ��-��-�?ad� -d��• �D� Oo?�
Property Description in� �
Taxing District (Fi'efy- Towrt-Township):
Parcel Number 1
If buying on contract: Owners name �'� "inp1e °""e`�
Township
or legal description shown on tax statement:
�f l�:.z NL-�� /7� y�/c �?•ccG• t/a.�
Contract recorded in Recorders Office - Record No. Page
If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that
structure is used to produce income, describe the use and portion of the property utilized to produce income
Any other counties in which individual owns or is buying real property:
the a�ve statement is true, correct and complete.
�.
�
County Township
�'Spnat�CX/ ��� Slreet AEtlress ' Ciry. State ane Zio Caae
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Lantl not exceeding 1(one) acre immediately
surrounding residential improveme�ntys
Other Land � � � F 1 /
Total Land JJ 1.�
Residential Improve�t� 2 j979 - Dw�e,lling
��j� ^ "� Ga(age
r / (�4�lGQ�(pi(� Tolal
Other Improvem ts AUDITOR
T�Improvements - Line (6) plus (7) equals (8)
I,.,.,,_aby certiTy the above is true. correct. and complete.
ol Assaswe
True Cash
Value
(t) S^oo
(2) .T�n-A
(3) / �
c4� a 9�� o
(5)
(6) � 9 i � o
(�) —
(g) c�l-/� 3C3
ACTION BY AUDITOR -
Assessed
Valuation
� 70
jj�jjj�jjj
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�i��
�/��` %
Homestead
Valuation
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Approved: �, �O o z� Date: �-�`z" 7