Homestead_Rexing (14) STATE FORM 535t0(GJ/SIO) ' TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF AL-COUNTS,A% PRESCRIBED BY 111F.DFPARTFENT OF LOCAL GOVERNMENT FINANCE IC 61.1-224.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY ON'NERS
101 N.Main Street Individuals and married couples are limited to one homestead standard deduction_ As the receipt of this deduction becomes
Princeton,I N 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
F HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligibk to receive the
• benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information wilt he kept confidential and can only be accessed by authorired county officials.The Deparenen;of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
MAY 16 2011
•
Taxpayer Name Location Address
C.J. Rexing, Todd A/Rebecca L
11925 S 200 E
GIBBON COUNTY AUDITOR X HAUBSTAOT IN 47639
3031
Todd A,Rebecca L Rexing 111I1li11]IIIIIIII�IIIIIIII II1IIII�ll 1111DIIIIII ILIIIIIII I HI�11IIIIIDID @II II
11925 S 200 E
Haubstadt IN 47639
State Parcel Number / Legal Description
26-23-09-300-000.656-024 / PT SE SW 9 410 2.50 AC
•
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.
r`- • PART 2: TAXPAYER INFORMATION
0. n First Middle Last
Anmhon y �— C/p PeA;h5
t-
Mailing Address(number and street.city,state,and ZIP code) t e as property address
11952 3. d oo e W/a.cdicfaolf _TA/ y7 n
Spouse First Middle Last
eeheera Lynn Pm;n9
-
— Mailin Address Number and strcey ci_ _ _,._____
g ( ty;state,and ZIP care) _ `_ a as property address --.- - _-
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
d�R•n�t CLAIM FOR HOMESTEAD PROPERTY TAX FORM � Y AR
'�- � = CREDIT/STANDARD DEDUCTION HCio x
'� J' State Fwm 5473 (RS / 10-01) � v�
°i� Prescribed by the DepaM1ment of Local Govemment Finance
INSTRUCTIONS: See reverse side (or /iling instructions.
��i`'�*--''-. ;. .�i�•—� ..+_.-''::�' 's'-:.'=:"CERTIFICATIONSTA7EMENT"<::: . ' �_ .
` .. � , ... . .. . . .
�+. . . .._ _, . . � -. ., . .
. . _
.
I(We) certify Ihat on the 7sl day of March, 20_
I(We) occupied as our principal place of residence the following descnb d real pro y for which a Homeslead Propehy Tac Credit is hereby Gaimed:
�f�✓e) owned ❑ We buying under contract
�-lave a benefidal interest in ihe entiry ihat is Iiable for the property taxes on the pmperry and that ovms the property or is buying urder a conuaU.
��`c--r"s.r'v>':.. s`r.'Xc$`F7?�`:;u+-�'3"z.,.:#:fir`��� '�� .s.�`" :`hi'a;:CONTRACT.'RECORDEDi:.;,:. .. '__ -1.j ..x� ,,s ���. � .
I( buying on contraa, Fee Simple owners namea
RecoNefs ofice where conuad is recoraeE Rewrd number Page
Caunty ' Tavnship � T�cing ' (city town, fownship)
�n ber Legal descdption I e pmperry in question:
.. 6 �p ^ � �i .2's�i o.00em
If any pohion of Oie residentlal sWdure w Ne land not exceeding one (1 � acre t�al immediatety surtounds that sWCture is used to �
oF the property uGlized to produce inwme. �
�G-a3-o9_,3oo-6cb. GsG-o��
Tavns�ip
I hereby ceAify the above statements are W e, correcl and complete.
�re�s (�mber and streel, cdy, stare, ZIP code)
Land not exceeding 7(one) acre immediately
surrounding residential improvemenls.
Other land
Tofal land (line 7 plus line 2)
Dwelling
Residential improvemenls
Garage
O�her improvements
Tolal improvements (line 4 fhrough line 6)
Ttial value (line 3 plus line n
1 hereby ceAify ihe above is We, correct, and
complele.
Verifying action - Signature of Audilor
20_Pay20_
Lesser of tY2 Homestead
ValuaGon or 56,000
(�)
�Z)
(3)
(4)
(5)
(6)
l�)
(8)
Signa[ure ofASSessor
County
5
61.1�7)
MAR 2 5 2002
Date sgned
Date sgned
SgnaNro otlwditor /(/.� / , / (�\( I ��� (+� ' \
/ �/i'S � l �.J
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