Homestead_Jones (5)CLAIM FOR HOMESTEAU PRUPEflTY TAX CfIEUIf FUII YEAIi
SEE BACK FOR FILING INSTRUCI'IOfJS
19�
'�� ° � — a ° -Z 9.L -o'o
�� (We�� ' ._...._. ... cr.ilily Ih:il qn U�n 1s1 cl�y ul
'��4arch, 19 , I, (We) occupied as our pr' I pl ol residence Ihe folluwiny described ieal property lor
hich a Homestead Property Tax Credit is hereby being claimed: �
I, (We) LV/owned
❑ are buying under contract .
❑ have a bene(icial interesl in the taxpayer
Properry Descriplion in
Taxing District (City, Town, TownshiP):
Parcel Number �
���n�J '� �iee simpie o.ner�
Ii buying' on-contract:-Owners name
ty
Township
or legal descriplion shown on lax staternent:
�a:s�iU � 3-a-�.� i, r�� —
JUN 2 7 19�j�Contract recorded in Recorders Olfice - Record No. _Paye
If any portion ot lhe residential structure or the land, not exceeding one (1) acre that innnediately surrounds that
structure is used,to produce income, describe the use and portion of lhe property utilized to produce income
"'iit'�u�N �.(�rc� S
� Gllilt�nn r/
Any other counties in which individual owns or is buying real property:
I hereby cerlify the above stalement is true, correct and complete.
nao�ess
County Tov✓nship
r�q�. .^,mir ,un z�n r.ovc
Individuai either owns or is buying under a contract �hat provides he is to pay Ihe property laxes
on the residence, .or has a beneficial interest in lhe taxpayer.
- FOR ASSESSOR'S USE OIJLY -
� True Cash
. � • Value
Land not exceeding 1(one) acre immedialely ,
surrounding resideniial improvements 1�) _ _
Olher Land
Total Land
Residential Improvemenis
. Dwelliny
Garage
7otal
Otlier Improvements
T!�mprovements - Line (6) plus (7) equals (8)
I i,a��by cerlify lhe above is true, correcl. and complele.
S�qmmre oi Assesw�
(2)
(3)
(41
�s)
(�1
( i ) ----
�
- ACTION BY AUDI1UIl -
nm�rovcd:----� � .1!(_! .!L' " ----
nssessed
Valualion
— �,.,,:
Homeslead
Valualion
� _a7__��.
I�:d�•
SfA�EFOR\15l<59(tU�g.10) ' tAFASUREAFORAITS-IT
MPRO\'ED BY 57ATE BOAAD OF ACCOI .MS. 3009 PRFSCRIBED BY i}fE DEPMTfE\T OF LOCAL GO\'FR \¢\T FI\ATCE If61.1-?:-B.1
Individuals and married couples are limited to one homestead standard deduction. As the ireceipt of this
�leduction becomes more 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 tlie 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
�vill be kept confidential and can only be accessed by authorized county officials. T6e Department of Local
Government Finance will use this information to create tools that will help couoty officials eliminate
homestead fraud.
,�, �. � ..�
Tunaver Same Pronem Address $bte Par<el Yumber Leeal Descrioliny
La���ence / Nancy J Jones � 198 E I50 S 26-1 I-13300-000196-0z7 PT Sw 13 2 I I I nC D-�
PRINCETON I� 147670 '
co,»prere a„a.et,,,,, �o: i�limpin��gggg�E99!!�l.�!!���!!;i�rii�r�l�llJ!!!�l!�E
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
� �
o.mer t j� ..\ �� J� C� Firat ,� nuaa�e 50 1-� CS' lasc
V-'
Nailvvd AGtlress (niaMer arH sVeel ury, state eM ZIP mtle)
�I Sama as wooarty adtlress
l t� � � I So s. 1�- r� ,��e -�--o � , -1 ,�D,��� � � D
so�
, MiaEle las�
/ V 1� TJ 7 �O �l � S
Mail'vp AaOress (nwroe� anC sVeet, firy, stata enE ZIP cotle) � Same as propery aOCress '
�� I
1 1 �( $ 1= . �.So �. t�r� N � e -1-0 ►� � � , � (� D
Social Seariry Munber (last 5 Elgltq Orivers Licensel5tate ID NwnCer past 5 EIQIb) s�= a,ner �aaa� :o�ry � ran a eaio.q
� �{= `� �( �
_ "
Each undersigned certifies, under penalty of perjury, thai the above and foregoing information is true and correa and that he or she is eligible to receive the
homestead standard deduction on this property. Each undersigned atso understands that, by claiming additional homestead deductions unlawfulty, he or
she may be liable for back taxes and substantial financial penalties. �
On+e� 1 Sigfacre Date ietaclqne �
�i a,�`'�-�''.��- �-- . -� l l - �- q -12- (
� �-) �� � �- ���
. � � � — � �::� ,.
� NOV 2 9 2012
n
�/
I N V