HomeMy WebLinkAboutHomestead_Blake STATE FORM nS'i :;.4NI 1PEASULE1 MORN MAP?...p
APPMtt'ED BY MATE 001aOOr AIYYK:YTS.br, PLMCMDEW BY TIM DEPMTNIMIT(w LOCAL GOVERNMENT FINANCE ICLI.I--r-AI
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.
• HEA 1344--200c requires taxpayers who receive the homestead standard deduction to verify tout they are eligible to recene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
fling..This information will be kepi confidential and ran only hc accessed by authorized county officials.The Depanncnt of
Local Government Finance will use this information to Breate tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Blake, Barbara/Kyle
509 Blaine AVE
.)C Princeton IN 47670
1568
Barbara Blake
509 Blaine Ave State Parcel Number Legal Description
PRINCETON IN 47670-2903 Y 26-12-18-301-000.031-028 019-00031-00 BALDWIN HGTS 2/3/4 BLK 9
111nI1n11t11uIut11/ 1 1611111 IIt11111116r1.II 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 INFORMATION
Owner I First Middle Last
rig Address(number and street,city,state,and ZIP code) Same as property address
SIJ61 BcA-i 1.1¢ 71/x, LIJCeio.J Z(J f-l7l 70
Spouu' `Ptrs Middle Last
Mailing Address(Number and street-city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driven's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sore
—
PART 3:CERTIFICATION - - -- --- -- —�-- •Each undersigned certifies,under penalty of perjury,that the above and foregoing information is we 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
•
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Slate Farm 5073 (R6 / 4-03)
Prasaibed by ihe Departrnent d Local Govemmeni Finance
INSTRUCTIONS' See iererse si� �r fifing insfructions.
FORM ,Y�p� YEAR
HC10 \�� �
-��� �� ��; �
��e� certify that on the 7st day o( March, 20_
I(We) occupied as our principal place of residence Ihe fol 'ng descnbed real property for which a Homestead:Propecty jai,EjeQit is hereby daimed:
% y
❑ I(We) owned ❑ Fve buying under wntract GIBSON CU�i� i e:,��;TQR
� Have a benefidal interest in ihe entiry Nat is liable (or fhe property taxes on the property and Ihat owns the property or is buying under a conVaU.
If buying on conuad, Fee Simplo owners name
RemNers olfice whera wnuaIX is recarded
'.�-��,'�s 4?�� C" ,�'Fr�",�r`:"r°3v-�^�-�'�.<sa` ��r
Cwnty � n n . .. Tamship
Legal description
Tating
Is �he
Record number � Page
Pmperry ❑ Mobile Momo (I.C. 61.
If any portion of Ne residential sW cWre w the lantl not exceedinp a�e (1) aae ihat immedialey wrrounds that structure is used to protluce income, describe Ne use and portbn
af Ihe properry utilized lo prafuce inwme.
��s�',A�f�� ASSES.�SORIISEONLY ` '? �� ��TRUETAX�� ASSESSED'VALUE 3{3HOMESTEADg�� � �'� �NpN¢RESI�ENTIAL`F'�-'�
��i'.Ji:„-' .�. �°''r..�.s -'.*_ L;fsl? :.77 ... � .^ii.���sF`.��i�'�`.�i7 3�` �c�VALUES ta;...5+' ;AT.s100% OFeTf V� �'� VALUE `.3s.t �,_..3"� ��a-V�.�'°�-^=�d�
Land not exceeding 1(one) acre immediately ��`�,,.� `', 4"�*- ��,�vr;
suvounding residentlal improvements. (�) �h'��7�,}r�,� �r- �".."�"
sz r _- .h. -F?
Other �and l `�' �`s� �i'�i �
(2) Ff� �:.se.�--y
Tdal land (line 1 plus line 2) �3)
�. ��� .� tz`.,Y "
3 ;..: -ai r�"�
Dwelling (4) ^�,�y�� g�`7a,������r-� �.
�Residentiel improvements or Mnually ' `� ��'��° �''"`
0.ssessed Mobile / Manufxtured Home Gara e "���. '?� ,i�`c'
9 (5) -t.`-"�.'-��#���������k��
3z- '
Otherimprovemenis (6) � � �'���r`"� �`�
- � txP.`�a��,g
TUat improvemenLs (line 4 fhrough line 6) (�)
Tdal value (line 3 phs line n (g)
I hereby tertify �he above is We, conecl, and Signature ofAssessor Data signed
complele.
Verifying action - SignaWre oflwdiWr Date signed