Homestead_Seibert (9) SIAM RAM !!N,0.:/)wl MAS UFA FORM TB IA
.Vfl'ED BY Ma fillABO Or?init.-0'c._`VN etLSOUBt])BY TIF DFYARIVINT(W Brut.GOVERNMENT FINANCE lce-L1r-tl
Gibson Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101
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 e'er for homestead fraud.Ilumestead fraud causes higher tax bills for all;therefore.
Illi HEA 1344--2000 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing:.Ibis information will he kepi confidential and can only be accessed by authorized county n(licials.The Department of
Local Government Finance will use this information to create 1 vls that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Seibert, Kenneth V/Joy M .
RI 0,,.,
Ihd..,Wd.IN`67 476
11143 /a_5-647 S 9O Li
Kenneth V/Joy M Seibert Nauhsradi, TN
12564 S 40 W W 7637
Haubstadt IN 47639-8715 State Parcel Number Legal Description
I tlullnrltilnulltlt�ulndtlnrlrul1t 1t1u 11ut1u 111tttl 26-23-18-300-000.897-024 004-00897-00 PT SW 18410 .55 AC
X
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Ken n e-'A V. S)e i l,.er--
�g Address(number and street,city,state,and ZIP code) Some as prdpem oddi6s-- — --
i So,'re S Yo kJ // Zf
aUdsadi _.X y
/V 7o39-17AS-
Spouse First Middle Last
Joy M, cif'b.ert
Mailing Address(Number and street,city,state,and ZIP code) El Same as property address
a'147e 4.5 9Gooc
PART 3:CERTIFICATION
. Each undersigi a 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 Signature Date
•
wen+ xc io ism
Prescri0e0 By Sizte BoarE ol TaM Commissioners
To & FileE in Wpliwte
CLAIM FOR HOMESTEAD PROPEATY TAX CREUIT FOR YEAR 192�
SEE BACK FOR FILING INSTRUCTIONS
�(We) Qd��� ,�� --�l�C� �(� �� certify that on the 1st day of
� arch, 19�, I, (We) occupied as our principal pla e o residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contraci
❑ have a beneficial in re t in the taxpayer
Property Description in
Taxing District (f,i£� Tewrr,-Township):
Parcel Number
If buying Ofl contract: Owners name ��� simv�e owneq
D��-4o�7-O
�G-�3-/�-�Gb-GY.Y�. �'�-D��
_County �� Township
or legal description shown on tax statement:
/�T. .S'C�J ��C / �— 5�— / a , 5's 2c.e.�
Contract recorded in Recorders Office - Record
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:
�hereby certify the above statement is true, correct and complete.
County Township
` Individual either ow�g6r���'' ing under a contract that provides he is to pay the property taxes
on 'l�e r id�ce, has a beneficial interest in the taxpayer.
�/
- S SOR'S USE ONLY -
�%Y3�f97g
Land not exceeding 1(one)�e im e y
surrounding residential improvements AUp�T�R
Other Land
Total Land
Residential Improvements
Other Improvements
Dwelling
N-
Garage
True Cash
Value
(1) � � O
(2) `
(3) .5-0 0
�a� /S3�
(5) —
Total � (s) /S 3�, o
��� —
T�' Improvements - Line (6) plus (7) equals (8) (8) /-s 320
I�by certj�q�the above is true. correct, and complete.
Sg(umre ol
- ACTION BY AUDITOR -
i!b✓j
Assessed Homestead
Valuation Valuation
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