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Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N.Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
, Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
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HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
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Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
APR 2 5 2011
Taxpayer Name Location Address
C.3, Antey, Ruthanne
0 OHIO ST
GIBBON COUNTY
AUDITOR PRINCETON IN 47670
35
Ruthanne Antey 1111:miI_mil iii ill mil E1il111 mil 1110iiii_Kill ii__11III1El11_II_I In ill iniii hill
1005 E Ohio St
Princeton IN 47670-8701
111111111 I��"VI'I'I' 'lIlllllliii! l'II'IlltIllllll"1ttlltlt State Parcel Number Legal Description
26-12-17-103-003.368-02EPT NW 17 2 10.69 AC
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
Mailing Address(number and stmt,city,state,and ZIP code) ❑ Same as property address
,oa3 f (9 . - 2/- , c/0/974?a
Spouse First Middle) Last
tjMailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
.I I I 1 I I I I I _ e
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 I Signature Date
FOPA1 HC 10 7979 - To & FIM in Uupliwte
ResttiDeO By Siate Board of Tax fqmmi5sianers � �
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR�YEAA 19� � �/
SEE ACK FOR FI ING INSTRUCTIONS -_
t" ., O 9- o33b8- c0
�We) c i y that on t e 1st day of
rch, 19 I, (We) occupied as our principal place of residence the fo I wing described real property for
which a Homestead Property Tax Credit is hereby being Gaimed:
I, (We) Cf owned
❑ are buying under contract
❑ have a beneficial inter�,i%,in �the taxpayer -
Property Description in '
Taxing District (City, Town, Township):�
Parcel Number
If buying on contract: Owners
nty
Township
o_ I description shown on tax statement:
1 �)'� 1.J %y 17-� -id • �9�.�
, Contract recorded in Recorders Office - Record No.�Page
If any portion of the residential structure or tfie land, not exceeding one (1) acre that irtimediately 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 �
certify the above statement is true, correct and complete.
�
/ 'SfgnaNre - . Stree� naeress . . . . . ary, s�aee ana� z�o Wae , .
�
- �
' Individual either owns or is buying under a contract that provides he is t0���p� �es
on the residence, or has a beneficial interest in the tax ay�r_
'=� � _ _
- FOR ASSESSOR'S USE ONLY - JAN � ��8�
;. JAN. i989, .
� - - True Cash't' • � � �Asse�,e � Homestead
.. Value ��l�a�id Valuation
Land not exceeding 1(one) acre immediately
surrounding residential improvements
Other Land
Total Land
Residential Improvements
(�)
(2)
(3)
Dwelling (4�
Garage �5>
Total (6)
Other Improvements
T Improvements - Line (6) plus (7) equals (8)
I-_• certify the above is true. correcL and complete.
Signawre ol Assessor
Approved
1
(�l
(8)
Da:e
Date: / G/ ��