Homestead_Hopkins (3)e�^`R°g CLAIM fOR HOMESTEAD PROPERTY TAX R YEAR
sa�': CREDITISTANDARD DEDUCTION
State Form Sa73 (R2 / 5-92) �� �
�''"�' � lVOV 2 31993
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INSTRUCT/ONS: See reverse side lo� liling instructions. �
. � � � CERTIFICATION STATEMENT z
'"v )___ � G1/l . certify ihat on ihe 1st day of March, 79�/
'l ) occupied as our pr� place of residence ihe following described real property or wh�estead Property Tax Credit is hereby claimed:
I�y I(We) owned ❑ Are buying under contraci
I❑ Have a beneticial interest in ihe eniiry thai is liable for the property taxes on ihe property and that owns ihe property or is buying under a contract. _
CONTRACTRECORDED � � �
It buying on tontract, Fee Simple owner's name
Recorder's oHice where contrect is recortletl Record number Page
PROPERTY DESCRIPTION
Counry �_ � Township � _� Tazirg districi (ciry, town. fownship)
Parcel number Legal description
oo� -�►a��-oo ��� a-a- � r q, s 393 a,c.
It any ponion of the residential swcmre or the land not exceeding one (1) acre that immetliatety surmunds that struciure is used to produce income, descnbe Ne use and portion
of the property utilized to produce income. _
\ PROPERTY OWNED BV CLAIMANT IN OTHER COUNTIES
County � Township Counry Township
. —.� _
certify ihe above siatements are vue, correct and complete. I Si a ot
street ciry. srare. ZiPmde)
ASSESSOR USE ONLY TRUE TAX ASSESSEO HOMESTEAD NON•RESIDENTIAL
VALUE VALUE VALUE VALUE -
land not exceeding t(one) acre immediately
surrounding residential improvements. (� � " �
Otherland (p)
Total land (line 7 plus line 2� (3)
Dwelling (4) _
Residential improvements
Garage (5)
Other improvemenis (6) �
Total improvements (line 4 thiough line � (7)
Total value (line 3 p�s line � (g)
I hereby certify the above is Irue, correct, and Signature ot Assessor Date signetl
complete.
-�-h,ing aaion - Signature ot Auditor Dare signed
19_Pay19_
Lesser of V2 Homestead
Valuation or $2,000 S
SignaW re of Autli:or
ALLOWANCE
J
Gibson County Auditor
101 N. Main Streel
Princeton,IN 47670
�F'II.JED
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Indrviduals and married rouples are limited �o onc homcs[ced sta�dacd Jeduction. As the receipt af �his defixlian hemmes
mare brneficial. �here is more inttntire iFun ner for homestead (aud Homatcad fmud wuus ttig6tr tax 6ills (or all; therefore,
HEA 1344-?009 requires tazpa)srs wiro rcccive thc hamestead standard dcducrion to �ttify tha[ c6ry are eligible ro recen< thc
bcnefit and to prmide addiiional idrntifying in(om�ation necessary w nllow county gw<mment t> bener monitor homcstpd
filings. 7}tis infarmation will be kepi wnfidcn[ial and can ouly be att�ssed by auihorized comry cifticials. The Deparm�cnt o(
l.ocal Gm�emmen[ Finantt will use ihis infoimstion m cream tools that wili helD counry ofTicials�.elimirtate homesmad fraud.
MAY 2 4 2011
_ , C.'J.n�y
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GIA��N COUNTY AUDITOR
Randall S Hopkins �
2246 W 100 N
PrincetonlN 47670-8557
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Taxpaver Name
Hopkins, Randall S
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Location Address
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2246 W i00 N
PRINCETON�IN 47670
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State Parcel Number Le
26-11-02-100-001217-027/ PTNW 2211
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the cou
Addrzss (¢umber and strcct, city, sratc, and ZIP code)
5 dii;iu) I Drivcr's Liccnsd5tau m I��bcr (last 5
Address (\umb,fr and iveel, ciry. sutc, and 7.If cadc)
ID7
AC
treasurer.
y,�� s�� � p�y� �s �
JL'� I
Other (pleau spxify in Part 4 below)
� s�..
Middle
� Samc as property addrcss
Other (pleau spctify in Pazt S below)
�.__ . ._ ' ' _ . - ... _ .
undersigned certifies, under penalty of perjury, that the above and foregoing information is we and correct and that h� or she is eligible to
+e the homestead standard deduction on this property. Each undersigned also undecstands that, by claiming additional i omestead deductions
+fully, he or she may be liable for back ta�ces aud substandal financial penalties.
�l Signature Date Tclephone I
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ne
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