Homestead_Bolin SIAM Hum•)•MIRV/A,NI 1REPSUE[A;O0.1 T3-IA
.1PrMA'E13 Witt ATE M(10D(1E Art T*L%Ts.!orr1 PAISOURED BY nth DEPARTMENT(FLOCAL GOVERNMENT FINANCE K'6-I.1-124 l
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.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reeebe the
benefit and to provide additional identifying informnon necessary•to allow county government to better monitor homestead
filings.'Ibis information will be kept confidential and can only be accessed by authnrited county officials.The Depanntatt of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead Gaud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Bolin, Daniel W/Phyllis A
X 404\V Kentucky
(Princeton IN 47670
3660
Daniel W/Phyllis A Bolin
404 W Kentucky State Parcel Number Legal Description
Princeton IN 47670-2852
�I�r I'lII III IIPII Ili III II IIIIIIIIPIi It illIr II III IIIIItI 26-12-18-101-001.776-028 019-01776-00 PT NW 18-2-10.20 AC
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
DA—Ai el— l/V S Lffy /50C/
g Address(number and street_city,state,and ZIP code) [i Same as property address -- - '
- (70V *St ��n�e r ([7620
Middle Last
I�t��IC �ls A-N N &C/A)
Mailing Address(Number and street,city,state,and ZIP code) ('Fame 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.
Owni Signature k) .t () l T /va
•
a+s �,R4
a/'= , CLAIM FOR HOMESTEAD PROPERTY TAX
i��j: CREDITlSTANDARD DEDUCTION
., . ��� .,; � Sta;e Form Sa73 (R2 / 5-92)
ieu .
INSTRUCTIONS: See reverse side for liling instructions.
.. �
i' I I d'!+`��?)
JUL 3 0 1996
��we> aJ�v�u�_'t,l/ , w�J�I.A'.l�? �•�t�T ��-�/w) certify that on the lst day�r ��tOR�
�;) occupied as our principal place of resid�}ice the following described real property�for which a Homestead Property Tax Credii is hereby Gaime
r' (We) owned ❑ Are buying under contract
❑ Have a beneficial interesi in ihe entity ihai is liable for the property taxes on the property and that owns the property or is buying under a contraci.
- - - CONTRACT HECORDED - .. _
It buying on contract, Pee Simple owner's name � � � .
ReCOrder'S oKke where mntrad i5 recorded Rewrd number Page
Counry
Parcel number
Legal
I.L�-� - v� � � lo �
If any portion of the residential structure or the land
of the pwperty utilized to produce inCOme.
PROPERTY
disirict
i o�a-iu •ow�t�
(7) acre thai immediatety wrrountls that strucWre is used to produce income, describe the use and portion
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VA�UE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvemenis. (�)
Oiherland (p) '
7otal Iand (line 7 plus line 7� (3)
Dwelling (4) �
Fesideniial improvements
Garage (5)
o�
Oiher improvements (6)
Total improvements Qine 4 through lina � (7)
Total value (line 3 p�s line 7� (g)
I hereby certify lhe above is lrue. correci. and Signamre of Assessor IDate signetl
complete.
�'ying action - Sgnature ot Autlimr Date signed