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[,RUE FORM•moot:,%INI TREASURE(FORM 71-IA
APPROVED PT MOLE If M MYUB.TS.TNT IMENXTIBMOT THE DEPARTMENT Of LOCAL GOVERNMENT FINANCE IC 11I1r- I •
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples 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 1344-2709 requires taxpapen who receive the homestead standard deduction to verily that they are eligible to receive a the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
tiling.this information will he kepi cunEdenlial and can only be accessed by authorized county officials.The Depannent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
. PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Beloat, Christene Trust
• 221 F Pine ST
Princeton IN 47670
2631 •
Christene Beloat Trust
221 E Pine St State Parcel Number Legal Description
Princeton IN 47670-1621
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PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
0.Lod- X62 . ,� taaa -
1ddras(rdtra rand: -ei:y;ate,and.ZIP code)-- - _ _ _ _ __ 9.Snmar¢property.nddrncc_ _ _ _ _ _
22, 1 e b, &exi-125-0) r 4,1'4 l&
Spouse First Middle Last
Mailing Address(Number and steer,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)
sole
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
•
•
e%^��°
� , CLAIM FOR HOMESTEAD PROPERTY TAX
�; �� CREDIT/STANDARD DEDUCTION
,�.` �� State Porm Sa73 (R2 / 5-92)
�eu
INSTRUCTIONS: See reverse side (or liling instructions.
0
FORM YEAR
�,, H_C
. . e _�
MAY 1 �yy�
� �� s x�cz A � � Ly_,��� ��l LII � d�' .• certify.ihat on t�i6 � s� a r �n, �s_
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occupied as our principaf place of residence the follovring described real property for which a Homestead-PiopenyTa�eFi , �� reby claimed:
I, I(We) owned ❑ Are buying under coniract .
❑ Have a beneticial interest in the entiry that is Iiable for the property taxes on the property and thai owns ihe property or is buying under a contraci.
- - � � � CONTRACT RECORDED " - � � � .
If buying on contract, Fee Simple owners name . .
Fecordefs oifice where coniract is recorded Retord number Paqe
Counry
If any
at the
� � Township
Q��1.5-� � �I
f the re5idenlialSWCNre or Ihe land noi
utilized m produce income.
PROPEPTY
�
g one (7) acre that imrn
fown,
surrountls that structure is used ro produce income, describe Ne use afM portion .
PROPERTV OWNED BY CLAIMANT IN OTMER COUNTIES�� �
Couniy Township County Township
�_by certify ihe above statemenis are true, correci and complete. Signac e i am
Adtlress (numbei and s1ree1, dty. state. ZIP code)
ASSESSOR USE ONLY . TRUE TAX . ASSESSED HOMESTEAD NON-RESIDENTIAL
,VALUE VALUE- VALUE . � VALUE
land not ezceeding 1(one) acre immediately .
surroundinq residential improvements. (�)
Oiher land (p) ,
Total land (line 1 plus line 2� �3) �
Dwelling (4) � .
Residential improvemenis
Garage (5)
Other improvements (6)
Tota� improvements Qine 4 fhrough line � (7)
Totai value (line 3 p6s line � (g)
I hereby Certify ihe above is irue, CorreCt, and Signature ot Assessor Date signed
complete.
Verifyirg action - Signature oi Auditor Date signed
l� .
79_ Pay 79_
Lesser of 7l2 Homesiead
Valuation or 52.000
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