Homestead_Shoemaker RVE MI MI MO*ile'I W t TYrANarll FORM 3-IA
APrsrw'En ivy 1l■TL I1nUPM'MV)LL7t.'co. PtWRIBE➢BY OW DEPARffGYT(FLOA1 rt6[LSIFT7 FINANTE M 6-1.1-1:4.1
0 County Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
PRINCETON IN 47670 Individuals and married couples are limited to or homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.Ihomestead mud causes higher tat bills for all:therefore.
Ash-
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to receive the
benefit and to provide additional identifying infumtarton necessary to allow county government ent to better monitor homestead
filings.This information will be kepi confidential and can only he accessed by:HAW i>ni county officials.The Ikpanment of
Local Government Finance will me this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Shoemaker, Steven L/Cynthia M
RI .
Haubstadt IN 47639
7241' -- - — - -- - — - - - _ . . -- — - — - _. -
Steven L/Cynthia Shoemaker
1197 W 1000 S State Parcel Number Legal Description
Haubstadt IN 47639-8603
26-18-36-300-001.818-024 004-01818-00 HUNTERS CROSSING
lu II ctrIl II sect II rI rI nI nI n II II II FI tI uI nt II nI r I
X 2PT/3PT
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
Sf c'oh Lee S46aniakcr
—. tg Address(number and street.city,state,and ZIP code) — - — --2 Same as property odiass - —
1/97 w l000s f/accdsfadf, Zu £17639
Spouse First Middle // Last
0ygth/Q� 1'Iar/c S/loernaker
Mailing Address(Number and street,city,state,and ZIP code) 0 Same as property address
1/97 t✓ /oo0s /4 udsfadf , rd V17637
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. Signature / Date ,
•
•
��`���" - CLAIM FOR HOMESTEAD PROPERTY TAX
����...000���` � CREDIT/STANDARD DEDUCTION
1
�
�;� �� Siate Form 5473 (R2 / 5-92)
FORM YEAR
HC10
� a ��INSTRUCTIONS: See reverse side !or tiling insWCtions �
OERTIFICATION ATEMENT
I(We) certify that on the ist da�oo� March, 79_
I(We) occupied as our principal place of residence th ollowing described real property for which a Homeste d Property Tai( Cr�� is hereby claimed:
❑ I(We) owned ❑ Are buying under contract GIBSON C0�1N r�
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or �s ouyint,�{+lidT � tract.
� CONTRACTRECORDED
If buying on coniracl, Fee Sunple owners name
Recorders office where conVact is recorded . Recortl number Page
PROPERTY DESCRIPTION
Coun Tovmship Taxing Aistrict (dry, town, township)
a cel number _ legal descri io � / �
/
I( any poNOn of Ne residential 5[ruccure or Ne lantl not ezceeding one (1) acre hat immetliatey surtountls Nat structure is used to produce inwme, tlescribe he e antl portion of
the property utilized ro produce income.
lv - - - Qd - Gb/. � - 03
� PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township � Counry Township
S� nature of Gaimani
�ereby certify the above statements are true, correct and complete.
Address (number and streef, ciry, sia e, ZIP code ' '
.Q,Q/ ��'���a���.��f, �7G3S
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately (�)
surtounding residential improvements.
Otherland (2) -
Total land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvements I
Garage (5)
Other improvements (6)
Total improvements Qine 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby Certify [he above i5 true, Correct, and Signature of Assesor Date signed
complete.
Verifying acuon - Signature ot Audimr Date signed I
STANDAHD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead $
Valuation or S2,000
Signawr o uditw Date signetl �� /