Homestead_Belcher "AU FORD 5).W la-/NMI nFAStann FOAM 11A
APTROCEO BY MU relARDOf ACCOUNTS.Zan %lE(NBW BY Mt DEPARMEMf Of 1.0:.t GOVER,NMENT FINANCE MV t.I U4-I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and flurried couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than eta for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
4. HEA 1343-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necesory to allow county gm'emment to better monitor homestead
filings.This information will be L.ryv confidential and can only he accessed by authorized county officials.The I)epanmenl of
Local Government Finance will use this information to create testis that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Belcher, Donald W/Karen R
/ 210 S Center ST
Princeton IN 47670
460
Donald W Belcher -
210 S Center State Parcel Number Legal Description
PRINCETON IN 47670-2016
7 26-11-12-402-000.803-028 019-00803-00 SUNSET TERRACE 20
ltlnllntitllndutlli I III 11111 IIIIurrIIIII
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.
Spouse - First Middle Last
c.0() 0 Q a Mailing Address(Number and street,city,state,and ZIP code) Sat -property address
alb S >J kr Si- ivcthiv J c -7 :-7,a
__ _ _
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 homest d standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
FOAM HC 10 7979
HeSCriDM By Sute Bmrtl af Tm Commiuioners
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CLAIM FOR HO
�C
' E,2
92
PROPERTY TAX CREOIT FOR YEAR 192'�
To & Filed in DuDliw�e
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or9- oogo3_oo
,(We) � � certify that on the 1st day of
�tiarch, 19�, ,( occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
� are buying under contract
❑ have a beneficial i t�rest in the taxpayer
Property Description in 6�EC� County ,�� � Township
Taxing District (City, �ew�-TewnsM+p): ��z��
Parcel Number or legal description shown on tax statement:
._�e� �E�C_[ _(,�av , aW/a.�,�
If buying on contract: Owners name ��� �'mpie owner�
Contract recorded in Recorders Office - Record No. Page
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 complete.
� . o� �� ��oa�.—���s- '�. P ti;
'Signawre - �� /� Svret AtlEress City. S�ate a(W Zi0 �e
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' 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 res�ti�i�ov�n�
Other Land
Total Land
Residential Improvert�erifs 3 i979
(/1" . �/(��c.QQit
� AUDITOR
Other Improvemenfs
True Cash
Value
�i) i � o 0
(2) —
(3) % .ZUO
Dw�ng (4) �5�0
Garage �5> � ��O
Total �6� ��
Tn' ' Improvements - Line (6) plus (7) equals (S)
I,�oy ce�t+�y the above is true. correct. and complete.
Siqeumre o1
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- ACTION BY AUDITOR -
Assessed
Valuation
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Homestead
Valuation
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