Homestead_Blaize (3) ST(TE FORM w,IC l■+rv1 'TREASURER RON TS-IA
AMMO BY SLATE BMRD(K ACCU:,\TS.n,v PRISRUDW BY THE DEPARTMEW(f LIXAL GOVERNMENT FINANCE M64.1-_r'
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 net for homestead fraud.Ilomeste:ul fraud causes higher tax bills for all:therefore.
• HE:\ 1344--2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe the
benefit and to provide additional identifying information nemvey to allow county government to better monitor homestead
tilings.This information will he kept confidential and can only he accessed by authorized county officials.The Depannrent 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
Blaize, Stephen E
214 W Spruce ST
Princeton IN 47670
2431
Stephen E Blaize
214 W Spruce ST State Parcel Number Leaal Description
Princeton IN 47670-1426
1 1 1 1 1 1 1 t r r l l i l r t l l r r l l l I I I I t l l l l l l l l l l I l l i r t l l l l l l l F 26-12-07-102-000.198-028 019-00198-00 OLD PLAN 128 PT
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
5.TG-P14Cst4 G-itsGenve &A 1}6
'ID,Address(number and srxt,city:ante,cad ZIP code) - - -- I Same as property oddness.. . _ -__ _ _— _ _. _ _
a 4 t---s-f sp12V-C-C ST R.6---r 1 911W►cei l-417•1101n441 4'76?-0
Spouse First Middle Last
IA vh' 5Q Cs P (.441,1 Cr
Mailing Address(Number and street,city,state,and ZIP code) gI Same as property address .
2 E4— 1.-1Q S1 5pnAjGC sip-6-et 1 Pit bNckT -, 14-5)7 p3 J-sVa cflc n
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.
Ownc 1 Signature Date
FOflM HC 10 1979
PiewiEeO By State BaarG of ia. Commissfonerz
To 9e FileO in Duplica�e
CLAIM FOR NOMESTEAU PROPERTY TAX CREDIT FOR YEAR 19 � o `�
SEE BACK FOR FILING INSTRUCTIONS o�q_ oorQ�-o-�
(We) �—��— ��� �°� certify that on the 1st day of
rch, 19 �o I, ( e) occupie as our principal place of residence the following described real property for
, ich a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in � County p�-'�' Township
Taxing District (City, .�ew��wrtship): �h-�--�-��-
Parcel Number or legal description shown on tax statement:
o�.a P�Ati �ae Or.
If buying on contract: Owners name �'� s""o1e °"'"ef�
Coniract 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:
hereby certify the above statement is true, correct and complete.
�
z f9- w, SPft�C- sTRC-C-�' '
Sveet AOaress
1
County
Township
INfl�/�Itil� �7670
State ane 2ip Cotle
' 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 -
True Cash
Value
Land not exceedin�7 acr di ely
surrounding resident$� ir p v (�) �'fso
db _
Other Land (2)
Total Land APR 7-1980
Residential Improvem�rQs
�'• ' pUDI?OR
�s� a �so
Dwelling �4� ��
Garage �5� t�°�''�6
Total (6> '���
Other Improvements (�) —
Total Improvements - Line (6) plus (7) equals (8) (s) �
_I ��by certify the above is true. correct. and complete.
� td��
Si9naNre oi nssessor �I - �
v
- ACTION BY AUDITOR -
Approved: ��± —/i-t-�-�-�ti-
Assessed
Valuation
8a o
Sa o
.::; i: ,.7
' - i ��
;� - 3- 80
Oace
Homestead
Valuation
0
Date: '�' 7- � O