Homestead_Bates (6) STATE rO&aI ttgR:I s-Mt rhEASt[UA FON 73-IA
APPROVED BY WOE&t OOF MYTteNE5.9x PlEARrem BY TEE DEPARTe47 Q LOCAL 60V2RNMENT FINANCE IC I.t-r4I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
0
HEA 1314-2009 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 Depanment of
Local Government Finance aill the this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY ECFORMATION
Taxpayer Name Property Address
Bates,Timothy G/Lana W
1611 Cottonwood DR
Princeton IN 47670
700
Timothy G/Lana W Bates
Northbrook Hills
1611 Cottonwood DR State Parcel Number Legal Description
Princeton IN 47670-3323
26-12-06-401-001.045-028 019-01045-00 NORTHBROOK HILLS 38
I n II I l II etI uI III II nI II I I I I n II Inv II ru II n IIr I
•
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.INFOR%IATION
Owner I /// ��� F�iirstt ^ , Middle Imp Last
1 L inA-0— v .“ �P�c G ✓ \/ c l slims ti
Tg Address(number and street,city,state,an IP code) Same as property address
(Si �'�
Spouse First Middle Last
Mailing Address(Number and street,city,stale,and ZIP code) Wane as property add
I� S
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
.
0
� � � - � -- "_`
�
i��:,�.a CLAIM FOR IIOMESTEAD PROPERTY TAX
(d -� �; e
� CREDIT/STANDARD DEDUCTION
`��� Stale Form 5473 (f12/1-90) .
'�� INSTRUCTIONS: See reverse side lor liling insUuclions.
CERTIfICATION STATEMENT
'� -
- 9� ��� _ ��-- �'
fORM YEAR
tIC10 �
cerlify Ihat on the 1s1 day oi March , 19 ��
I(We) occupied as our principal place ol residence Ilie fol iny described real property lor wliich a I lomestead
rroperty Tax Credil is hereby clairned: I(We) owned ❑ �re buying under contracl
I lave a beneficial interesl in Ihe enlily Iliat is liable lor Ihe property laxes on
properly or is buyiiig il under a conlracl.
COMTRACT RECORDED
on conlracl, Fee Sitnple Owner's Name
's olfice where conlract is recoided
I N��ber � �` � _ I Legal
�I
r�y and Ihal owns lhe
PROPERTY DESCRIPTION
Taxing I�"i�'irycL(Ci� town, lownship)
iv I
II any portion of tlie residential slruclure or Ihe lend not exceeding one ( i) acre Ihal immediately surrounds Ihat slruc
Wre is used to produce income describe lhe use and poriion of Ihe properly ulilized to produce incorne.
PROPERTY OWNED BY CLAIMANT IN OTIiER COUNTIES
ASSESSOR USE ONLY Tf7UE TAX VALUE ASSESSED VALUE IIOMESTEAD VALUE 17011-RESIDEIITIAL
VAIUE
land nol exceeding I(one) acre immedialely
surrounding residenlial improvements ( � )
Otherland (2)
Tolal land - line (1) ptus line (2) (3)
flesidential improvemenis Dwelling (4)
Garage (5)
Olher improvemenls (6)
Talal improvemenls - line (4) tluougl� line (6) (7)
Tolal vatue - line (3) plus line (7) (8)
I hereby certify Ihe above is true, SignaWre ol Assesor Date Siyned
correcl, and complele
Verilying Action - SignaWre ol Audilor �ale Signed
1989 Pay 1990
Lesser o( 1/2 I lomeslead
Valualion or $2,500
ol Audilor
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991 1991 Pay 1992 19 — Pay 19 —
Lesser ol 1/2 I lomestead Lesser ol 1/2 Homestead lesser ol 1/2 Homeslead
Valualion or $2,000 Valualion or $1,500 Valuation or $1,500
Dale /S/igne�dy
.�"`I� /�