Homestead_Wilhelm STATE FORM 53569(R3B-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6.1.1-22 5.1
. ' IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS : .
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
c' auction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
auses higher tax bills for all; therefore, HEA 1344-2009 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 filings. This information
will be kept confidential and can only be accessed by authorized county officials. The Department of Local
Government Finance will use this information to create tools that will help county officials eliminate
homestead fraud.
. -PAR I: P•OPER 1' ,'FO'NIATION • - •
•
Taxpayer Name Property Address State Parcel Number Lent Description:
Lawrence R/Melanie 10161 S HUNTERS CROSSING 26-18-36-300-001.885-024 HUNTERS CROSSING 7
Wilhelm HAUBSTADT IN 47639
Complete and return to: IIff1IIDl1COH11Qll EMINDHJt11�ll11711t71O�f11171®
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 G ILti LLIILLG 111❑I
. - _ PART 2:TAXPAYER INFORMATION
Owner 1 First Middle last
Lt cur-enee- Airy--/- AL.I hek
MaOing Address(number and meet.city.state and ZIP code) I� ne as property address
/O/4J S. irJtis �t0.ssii- ,0 . A-a skull- JR 1/7437
Shame First Middle Last
Th ela►'1 r Pi he6 • Lk)1 I P)01
Madtrg Address(number and street.ay.state and ZIP code) I same as property address
/O/jig 5 ThI! i t.1/s el?5sir1c' pi . (1�a SO/// J,4 e/7b f'
I
Ead-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 daiming additional homestead deductions unlawfully,he or
she may be liable for back taxes and substantial financial penalties.
Owner 1 Stinnk:re Date
-. PART 4:ADDITIONAL INFORMATION
' �.'^�" - CLAIM FOR HOMESTEAD PROPERTY TAX FORnn YEAR
' CREDIT/STANDARD DEDUCTION HCto
� Stata Form 5473 (R2 / S92) - �
r
\: ..'-rri..zi - . ' , . .
6 �
\��� � INSTRUCTIONS: See reverse side for7iling instructions. � {`- : .
��3'� �
� CE TIFICAj10N A M NT
I(We) �certi� t�hNo�the �fX� of March, 19_
I(We) occupied as o r principal place of residence the follo �ng described real property for which a Hom�d Property Tax �dit is hereby Gaimed:
-cu. : �; r� ,- /
❑ I(We) owned ❑ Are buying under contmct GIBCO�; ��y "i P�, a i �niT�o
❑ Have a beneficial interest in ihe entiry thai is liable for the property taues on the property and that owns the property or is buying�under a contract.
CONTRACTRECORDED '
If buying on contract. Fee Simple owners name
Fiecortlers oHice where con[ract is recordetl � Record number . Page
PROPERTY DESCRIPTI
Counry Tow�ship Tazing C� trici (ary, . t ship) �
arcel number /� T Legal description
OO�V/� �V
If any ponion of Ne residential structure or the IarM not excee ng one � acre that immediately sunounds that swcture is usetl m r uce � e, describe the use and portion of
ihe property utiizetl m praduce income.
- - - �X/. d�� = c�1
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES -
Counry � Township Counry Tawnship
SignaNre ot claimant
�ereby certify the above statements are true, correct and complete. ��M��N ��f�
//�
dd number antl strcet, ciry, state. ZIP mde)
RR#� 0 .SIo�G �-4kbsfiul�- �?N 4?�e39
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Landnotexceedingt(one)acre�immediately ��) -
surrounding residential improvemenis.
Otherland (2)
Total land (line 1 plus line 2) (3)
Dwelling (4)
Residential improvements
Garage (5)
Oiher improvemenis (6)
Total improvements (line 4 Ihrough line 6) (7) _
Total value (line 3 p/us line 7J (8)
I hereby certify the above is Irue, correct, and Signature ot Assesor Dare signed
complete.
Veritying action - Signature of Autlitor Date signed
• STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead �
aluation or 52,000
Si at oi Audit r Date s" ned
—o� �3 -0�00�