Homestead_Seibert (2) STALE/ORM! tr!'-o t TREASURER PORN ZtA •
.ArrMNEn MY MArr.nrsROnr ACCOUNr:.2n, PtrrmamD BY mr DEPARTMENT(41ERAErovrrtNMCNT PTANCEt(
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
S more beneficial.there is more incentive than ever for homestead fraud.I lomesteal fraud causes higher tax bills for all:therefore.
HEA 1344--7009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to receive the
benefit and to prm'idc additional identifying information necessary to allow county government to better monitor homestead
filings-This inl'nrmation will he Dept confidential and on only he accessed by authorired county officials.The Ikpannent of
Local Government Finance will use this information to create tett that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Seibert, Chad S/Staci
R 3 Box 314 A
IIAUBSTADT IN 47639
10890
Chad Seibert
11658 S US Hwy 41 State Parcel Number Leal Description
HAUBSTADT IN 47639-8842
�t�tt��tt t�t��t Plt��t�t�tt�tt�t�II�t t�tt�tt�t�l�t�t�tt�tt��tr� 26-23-08-400-002.232-024 004-02232-00 PT E 84101.565 AC
X
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
C/40/ 5, c--)ep 6 er
�Ig Address(number and sweet.city,state,and ZIP code) - // — - - —- ��'/Same as property address --- - - — - -
/165S 5 . 9,S. 64—y LI / �71-0e-,er(y rn"f( Co -a 3/v,7
Spouse First Middle Last
Sretc /1/. Ser'6er
Mailing Address(Number and street,city,state,and ZIP code) g Same as pmpeny addtos
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 properly. 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
CREDITISTANDARD DEDUCTION
Stete Form 5473 (R6 / 403)
P2safbed by Ma DepartrneM d Lxal Gavemment Financa
INSTRUCT70NS: See ievarse side /or�lirg instnwctions.
FORM � YEAR
HC10
� A
i�
� �e) � � � � � � � � � - � certify on the 7 s4dey ot March, 20
�// �v i.v �,
I(We) occupied as our principal piace of residence lhe following described real property (or which a Homestead Propert���c Credit Is hereby daimed:
❑ I(We) owned � ❑ Fve buying under contract G�g$ON COUNTY AUDITOR
'i Have a benefidal interest in the entity that is liable for fhe property taxes on the properry and that ovms Ihe property or is buying under a wntraG.
If huying om m�irad, Fee Simple owners name
olfice where wnirad is retorded
cou�ry
number
ToxnShip
/
Record number
Tacing dis)t(t+ (dty, fpwn, townshiP)
�he P�Pe in question:
I properry ❑ Mobila Homo
Page
If any portion of the residan8al sWdure w the IanA not exceeding one (1 � aae t�at immeEiatey surrounds that swaure is used b protluca income. desvibe Iha use and portbn
ot ihe praperry uWized b produce income.
/. s6s
a.
� � �'r `,'" ��� T i iz ''�`' sTRUETAX.� k ASSESSEDVALUE �HOMESTEAD �'�"cy�'�'��� `�
���'i`� ��',� '�t "' � 'Z"r �" NON;RESIDENTIAL
�.`,����Y�ASSESSOR�USE ONL�� �i�� w�s- ���UE',°is�,� _AT.t100°/a OFµTN� �,y� VALUE �` � '-� •'VALUE
� rs'�. � a�^54+'.�'r_..,,�r� �'h.��e�Yk}-.'�`a`n.:a....�.. �������
Land not exceeding 1(one) acre immediatety ��� �+;� .�.;��+��3'rN?
surtounding residential impmvements. (�� .<_, s.°..,s���� �„�".. __�
�2 s;F,=- . `�=.
� F_.��,��` �. _ _
Otherland (Z) i���s� s��� .'
�rw:3?. •�
Tdal land (line 7 plus line 2) (3)
.-�*�-�.t��: ' -r� '�r...
Dwelling (4) �,y-� �a��� .. '��
Residenlial improvements or Mnually "�d ��"� -' ' �`-
Pssessed Mobile I ManuFactured Home Garage 5 '�� ,_����r,�
( ) �v's�. �:_,��.'� r�,.. �_:
._ ,�=<,-� -._..�
Other improvements 5 ».� xy<;`'��.'
( ) �=-_:�:�'Y"�N"�k.�`�
Tdal improvements (line 4 through line 6) (��
Tdal value (line 3 ples line n (g�
I hereby certify the above is Vue, corred, and Signature ott.sseswr oate sgned
complete.
Verilyirg action - SignaWre ofAntlitor Date signed