HomeMy WebLinkAboutHomestead_Brown SIAM FORM!1t to•+nO TREASURER FORM DS-IA
Arrww'FD ov SIAM Da•RD Or Mr"'.;T,.9v FAFYRThm BY Tilt orrMTEITOE LOCAL GOVERNMENT W:AYCE It 4-1.1-2:4,1
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 exer for homestead fraud llomesteml fraud causes higher tat bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive be homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necesary to allow county government to better monitor homestead
filings:.This information will he kept contidemial and on only be accessed by authnrieed county officials.The Depannem of
Local Government Fiance will toe this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORDIATION
Taxpayer Name Property Address
_ Brown, Charles W
t 805 E Broadway
Princeton IN 47670
3307
Charles W Brown
805E Broadway State Parcel Number Leila! Description
Princeton IN 47670-1921
IIIIIIIIIIIIIIIIIIIIIII IIIIII11rIII11I1111 IIIIIIIIIII 26-12-08-301-000.257-028 019-00257-00 HIGHLAND HOME 17
PART 2:TAXPAYER INFORMATION
Owner I First �1 , / ��} Middle Last
4 e Address(number and street,city,state,and ZIP code) 3-Same as property address — -—
Spouse First Middle Last
Mailing Address(Number and street,city.stale,and ZIP code) 0 Same as property address
Social Security Number(last 5 digits) Driver's License/Stare ID Number (last 5 digits) Other(please specify in Part 4 below)
Sae
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.
Owner I Signature Date
•
�.� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fwm 5473 (RB / /-03)
Presrribed by Ihe Department of Local Govemmenl Finance
INSTRUCTIONS: See reverso side /or liling instntclions
. �
� ' �'
y i ' 1 !�r
s _ I
OCT 21 2003
� ('�`�e) certi BBFl1� t� .�'n�iae�dc� I
I(We) occupied as our principal p ace of residence the following descrtbed real property for which a Homestead Property T�c Credit is hereby daimed:
�I(We) owned ❑ Are buying under wnlract � �
Have a benefidal interest in the en6ty that is liable for fhe property Wxes on the property and that mms the property or is buying under a conVact.
If buying on contraq. Fee Simple owners name
Recoidefs office where conVaC is recorded
CounTy
Parcel number
T I �i � /^h � .C'l .�
Tavnship
If any portion of NB lesitl¢ntWl aWctura w Ue
of the properry uLLzeO b produce i�ome.
Record number � Page
aistrir,t (ciry, town,
�\ I� I Is the property in question:
y ❑ Real D�operty ❑ Mobile Homn (/.G. 6f.7-�
one (7) aae that immediatery surrounds that swGUre is used b D��uce income, desaibe the use and poNOn
_ �. , s C°t ff.. -�" ",e'�'.`�.� -' ' ,r ' . _ i : -'+'.� !;• - �,. vr�..... _�
��: r�. �.... �z�i�n'����,—,,;STANDARD:DEDUCTION�uiowa+ce��z�.;���.;;;�`�„���+.���
20_Pay20_
Lesser of 1/2 Homestead 5
VauaUOn or 535.000
SgnaWre of AudM1Or Dale signed
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