Homestead_Boxell STATE FORM 51569(RM/8-IP) TREASURER FOILM TS-IA
APP{LOVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE la-LI--n-5.1
IIVIPOR•TFANT NOTI€E TO'HOMESTE'AD PROPERTY OWNERS •
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
•_auses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
standard deduction to verify that they are eligible to receive the benefit and to provide additional identifying
information necessary to allow county government to better monitor homestead filings. This information'
will be kept confidential and can only be accessed by authorized county officials. The Department of Local
Government Finance will use this information to create tools that will help county officials eliminate
homestead fraud.
i, PARTI: PROPER Y INFORMA, 'ION •;r.+G: •
Taxpayer Name Property Address State Parcel Number Leal Description:
Joey M/Karen L Boxell 524 N'MULBERRY ST 26-12-07300-000.225-028 PRINCE PLACE 39/40/41
PRINCETON IN 47670
complete and return to: • 11111[1111111MIEME11111111011111[I][If DIIJIME
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
Amer 1 First Middle r Last
Jd 6 V
Mailuq Address(number a4 sweet,city,state and ZIP code) '
rl/J Same as Property address
.suss First Middle Last
Mailing Address(number and street.city,state and ZIP code) r;lame 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 Si nature Date
t ,.0 PART 6:3 ADlittrj'IRNei.L 1N 170Rl41dr)ION
•
I-tb 1 2013
mason COUNTY AUDITOR
PreSCnbad 111' $Iele POaiO al Ia, f.ummRSmne�S
CLAIM FOR NOMESTEAO PROPERTY TAX CREDIT FOR YEAR 19�_
— - �
S[E OACK FOR FILING INSTRUCTIONS ./ oi9_ Da2z5�pp
V �
'(We)� �• � 4r1Rcri �• �� certify that on the 1st day of
�3rcli, 79_ �, I, (We) occupied as our principal place of residence the (ollowing described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) l�owned
❑ are buying under contract
� have a beneficial interest n the taxpayer
Property Description in �� County �`� Township
Taxing District (City, Town, Township):
Parcel Number
If buying on contracC Owners name °�� ""'o'� °"""'
or legal description shown on tax statement:
j\ ,L,rn,w�JCac�� 34I �fol �1
Contract recorded in Recorders Office - Record
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
��J d
!e1 Aoa�ess
Individual either owns or is buying under a contract that provic
on the residence, or has a beneficial interest
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1 Ione1 �cre immediateiy
surrounding residential improvements
Other Land
Total LanA
Residential Improvements
Dwelling
Garage
(�l
(2)
(3)
(a)
(5)
County
is b pa'y11
� taxpayer
Township
ie property taxes
1UN i.: 1989
2.�- A ,�' o ��
True Cash Assessed Homesiead
Value Valuation � Valuation
Tolal �6� —
Other Improvements (�)
T� Improvements - Line (61 plus (7) equals (8) (&)
I<�by certify the above is true. correct. and complete.
$��Ulule OI ASSCS50�
- ACTION BY AUDITOR -
�
Approved:_ � �. �� .
oa��•
Date:. �-�1"O — --