Homestead_Zenthoefer S.• • a
'SATE FORM!Mt.lti()'MI TREASURES MEM 73-IA
APPROVED BY STATE aWNRDOF MSR WS.lnr PRIY11lBED BY ntr BFPARTAQ:fr(F LOCAL CM itNMENT FflSCE MHb22.4.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individual. and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
mom beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes 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
Minya.This information will he kept confidential and can only he accessed by authorized county officials.The Depanntent of
Local Government Finance will use this information to create awls that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Zenthoefer, Roy/Marlene 140S1,3 1 alp S
D ti n,..2o-,
Ilaubstadt IN 47639
11126 ��
Roy/ Marlene Zenthoefer
405 W 1200 S State Parcel Number Leea1 Description
Haubstadt IN 47639-8809
Ill l l l l l l l l l l l t l l l l l l l l l l l'11111111.111111 1..11.1111111111111 26-23-18-100-001.116-024 004-01116-00 PT NW NW 18 4 10 .628
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
RD Jo -2ev. A;2_ e_r-
iiptg Address(nt. bey and street,city,state,and ZIP code) ❑ Same as property oddres- — -
Lths 1k) \anos
Spouse
p First Middle Last
‘A — jcvly\- Ze � oc\-e
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
14 0 C lk) \a-0 0 t -cu bcs6 -
— - - ' - -- - ---- -----
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
unlawfitlly,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date
-
•
FORM MC 10 1979 To Be FileG in Duplicate
P�ewri0ed By State ew�d al ia. Commissfaners
CLAIM FOR HOMESTEAU PROPERTY TAX CREDIT FOR YEAR 19 �%
BACK FOR FILING INSTRUCTIONS
�+/e) � certify that on the.lst day of
��� ch, I, (We) o�cupied as ou r' cipal place of residence the following described real properry tor
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract �
❑ have a beneficial int�rest in the taxpayer
QO�-O///� - Do
Property Description i County �'a–O�^� Township
Taxing District (�6it�y--�ewa- Township): �
Parcel Number or nlegal description shown on tax statement:
{'i, n,i (.� << N � % I Y- �/- i o . (o � �'�.
-�
If buying on contract: Owners name �'� �""�1e °""ef�
Contract recorded in Recorders OfTice - Record No. Paoe
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: County Township
�hereby certify the above statement is true, correct and comp�ete. '
;"=��S2a,.�_
, a _ �
'Sign Street noaress C1ty. Sta:e ana Z�o �aae
` Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence. or has a beneficial interest in the taxpayer.
FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immediately
surrounding residentia��y�t� �
Other Land � �
�gs
Total Land
Residential Improvements ��jN 21 i979 Dwellin
Other Improvements
9
�Garage
� AU/� Total
rovements - Line (6) plus (7) equals (8)
certify the �bove is ,t�ue. correct. and complete.
Si�nacure t nsseswe
�
Approved:—__,��
True Cash
Value
(1) .� tro
(2) ' ° —
(3) � C9—o
(a� ) �3�"a
�5� ��._..-�=-Q
(6) � ��� O
(7) — ° �
(g) j' D
- ACTION BY AUDITOR -
Assessed
Valuation
/7 0
Homestead
Valuation
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Date: ��{__�__'