Homestead_Berry S'Is E I ORM!1y.IP`t SAM ltTASUIQ FORM IS-/A
A[rMw ED BY AVE BOAROOF MTh tVi.yr Pnn-XTIDrn DV THE DEPMneEIT OF LOCAL GWRRNMrIcr FINANCE 1C41.1-2:4-1
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 eser for homesead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the-holnesteud standard deduction to verify that they are eligible to receise the
benefit and to provide additional identifying infomtuton necessary to allow county government to better monitor homestead
filings.This information will he Lop.confidential and can only be accessed by authorized couny officials.'the Department of
local Goverment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Berry, Fred C/Kenna L
523 N Race
adiS Princeton IN 47670
2671
Fred C/ Kenna L Berry
523 N Race State Parcel Number Legal Description
Princeton IN 47670-1737
—I l l a i l l i 1 1 l 1 n f 1 n 1.1..1 1 r r 1 1 r 1- -- L O T R1
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Ce -e � . �%
_ _ ,g Addr:_s(nwnba-and stmt city,-„ate.and ZIP code) - — - G Same as property address- _ - -._ _ _ -
Sa 3 // 1?% c e 5 7 ft/ vi c e i tAJ / ,v 1 V 7G 7a
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZEE code) ame as property address
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
•
•
�`•,=•°4
�", CLAIM FOR HOMESTEAD PROPERTY TAX
s��'= CREDIT/STANDARD DEDUCTION "
,�:,��� State form Sa73 (R2 / 5-92)
, im� - ' • �
INSTRUCTIONS: See reverse side /or filing instruc(ions.
� � YEAR
�RM
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APR y � i9,g6
I e��-! Zj( j(jL 1 /_��(/IV n¢�C� �� �J�(J�/.� certify tha[ on the lst day of March, 19
;J�.'e) ^ upied as our principal place of residence the following described real prope r which a Homestead Propeny Taz Credit is hereby claimed:
owned ❑ Are buying under contract - .
❑ Have a beneticial interest in the entity that is liable for the property taxes on the property and ihat owns the property or is buying under a coniract.
. CONTRACT RECORDED .
It buying on contrad, Fee Simple owner's name .'- � � . , � .
Recortler's oHice where comract is recortletl Record number Pa9e
Counry
PROPERTY
Township
� � Legal description
fow�, township) .
✓��V ,-�j 7)I' V VI
If any portion of the residential stmcture or the land not exceetling one �7) acre [hat immediatey wrmunds lhat strucmre is used ro produce ixome. describe Ihe use antl portion
of ihe propeny utilized to protluce income. .
County
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
certity the above statements are tme, correct and complete.
numberandslreeLr.ti;5yte,ZlPcode) , _�
�
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ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
. .VALUE VALUE 'VALUE VAWE
Land not exceedinq 7(one) acre immediately
surrounding residential improvements. (��
Oiherland (p)
Total land (line 7 plus line 2� (3)
Dwelling (4) ( �-
Residential improvements'
Garage (5)
a
Other improvements � (6)
Total improvements (line 4 through line � (7)
7otal value (line 3 p6s line 7) (g)
I hereby Gertify the above is Irue. Correct, and Signature ot Assessor Date siqnetl
camplete.
.�rg aaion - Sgnature of Audimr Date signed
19_Pay79_
Lesser of 7l2 Homesiead
Valuation or 52.00o
STANDARD DEDUCTION
5
Signature of Autlitor ��'� � �/ � \ � / � � �� y"
a � /^-�11�/\/d�
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