Homestead_Seibert (8) win tOSMC3.'MIRl�nl nLAtyara FORM:11A PRIST.MM BY 1111 DEPARTIEW OF LOCAL• iarIMPORTANTrNOTICETO HOMESTEAD PROPERTY c~OWNERS 6-1.1-224.1,
Gibson County Auditor r
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one hmneucad uandard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ncr for homestead fraud.Ilomestead fraud causes higher tax bills for all:therefore.
HEA 1344-7(1[19 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to receive the
benefit and to provide additional idenurcre information necessary to allow county government to better monitor homestead
tiling..This information will he kept confidential and ran only Fc arce:+ed by authorized county officials.The Depanment of
Local Government Finance will use this information to create tools that will help county officials eliminate Mtmesead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Seibert, Janet S/Steven R
� L+ Cha.(3e
Fort Branch IN 47648�
9455
Janet S/Steven R Seibert
3926 W SR 68 State Parcel Number Legal Description
Fort Branch IN 47648
26-22-04-400-000.898-024 004-00898-00 PT W E 4 411 1.01 AC
PART 2:TAXPAYER 1NFOR\1ATION
Owner I First Middle Last
Slede Seibec r
Isip Address(number and street.city,state,and ZIP code) 12/Same as propeit addict/.39 al() w see- roil /grate.h Trit `- 7y18
Spouse First Middle Last
Jq e- ,5 Se;her r-
Mailing Address(Number and street city,state,and ZIP code) 'Same as property address
39967 to 54 4 firT lebQ ,veh flu Y76yc
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 attire Date
CLAIh1 FOR Hf�'�STFAD PROPERTY TAX CRmIT FOR YEAR 19 tS3
„ SEE BACK FOR FILING
INSTRUCTIONS �o �j (?!� D � �
1,�- S' ��_, .,/Q certif�that on �he �st day of
ncioal o ace of residence the follaainq describecl real
Cax CYedit is here�y being claimer.i: '/
Z, R'`e). [�v.ansi �� -o�o� -Q'7�-�D-Q�d. d� / b�- �� `�
� are buyinq under contract
� have a beneficial interest ' the taxnayer
Pronerty Description in �
Taxi.ng District (City, Twm, Zbwnship) :
County
'Ibomship
Parcel if�nnbes or legaT�description shawn on tax stater�ent:
i/�,' e � � �_�.�.
/� i
Ii buyina on oontract: o4mers name (fee sinrole rnaner) V�(� �- ��'2 �= S�—// /, of
Contract reoorded in I�mn9er's Office - Record No. Page
If any portion of the residential structure or the land, not e�eeding one (1) acre that
i�iately surro�s that structure is used to produce incane, describe the use ani portian of
the Dronerty utilized to produce i�ome
Any oti�er �imties in which i.ndi��idual owns or is buying real property: Coim Zbwnshio
I h.set>y certify the above state�nt is true, c9zrect ani caic�lete.
� ��/ -
k�giq�y� e Street Address Ci t y, State anl Zip C�
*Zndividual either owns or is buying imer a wntract that provides he is to pay the
oroperty.taxes on the residence, or has a beneficial interest in the taxpayer.
. - FOR ASSESSOR�S USE ONLY -
. True Cash
Value
Zand not exceecting 1{one) acre inm�ediately
sisrour�iing residential iu�rovarents (1) ��
Other I.and ( 2 ) —
Total Land
Pesidential InQzovene.nts
otn�- ImarovanPnts
� ' ?Jrorovenents - Line
I tierei�y certify the above
(3) '
Dwellinq (4) �7oS�
Garaae (5) —
Total (6> 3 % o So
c�� —
Assessed
Valuation
�°
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c6> ��us c�> �s cs> ca� 37os� �a 3s�
is true, correct, and mm�lete.
I�te
- ACTION BY AUDITnR -
Aauruv�: Date :
F�anestead
Valuation
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