Homestead_Brown (14) stATE ROAM ri5eiR'1f.'} fFAtntL V 7515
"MOVED ar 51171 ensreorornidts.mn PUflam or THE DFPMth'T OF LOCAL GOVERNMENT!NM:I:Elf Frt-r-u
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sundae]deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than eter for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
SI HEA 1144-2009 requires taspayers who receive the homestead standard deduction to verily chat they are eligible to recen e the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be accessed by authorized county officials.The Depanment 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
Brown, David/ Dawnelle
1701 Brentwood
X Princeton IN 47670
2300
David/Dawnelle Brown
1701 Brentwood State Parcel Number Legal Description
Princeton IN 47670-3319
ltltrllrttltllttltttill liIrrllrtrtillt11111 11111111 X 26-12-06-302-000.258-028 019-00258-00 NORTHBROOK HILLS 10
•
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
CIQievtce nt,vrd -Biro wry
M1 / (number , d code) i V ?cln c s ,V� 7 mp1MC V 1/76, 7D —
Spouse First Middle Last
3Itoatlle- /aii in a froGvn
Mailing Address(Numbe and street,city, tate,and ZIP cod - Same as property address
170/(Numbe
ooh / v e. Pr's 11 cP. rn, alY le7&7v
.
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 1 Signature Date
S
FOPM HC 10 1979
Pre5ai0ea By S�ate BoarE al 7a. Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 •�y
To Be Filea in Duplrcate
✓
SEE BACK FOR FILING INSTRUCTIONS o,q- ooas8-oo
'�(We) �� !-�!Q�r ���- `��-�-�-+� certify that on the 1st day of
eiarch, 19�`�`', I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
(We) Q� owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description
Taxing District (City, Town, Township):
Parcel Number
If buying Ofl contract: Owners name ��� s�mpie ow�erl
nty � Township
or legal description shown on tax statement:
��� -- - �
Contract recorded in Recorders Office - Record No
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: County Township
�here erti4y -w st_at_emwe-nt) is true, correct and complete.
v� I
'SignaNre Sveet Aaaress Gity. 5ta�e ano Zio .de
' 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 exceeding�(o�) ac�im�at y(�
surrounding residen al i rov nts �J (�) a o 0 0
Other Land (21 —
Total Land JUN 111979,
Residential Improveme /��L`k �2. Dwelling
�,f-' "�� �Ry Garage
(/ AUDITOR Total
�Oiher Imorovements
T
�
provements - Line (6) plus (7) equals (8)
certify the above is true. correct. and complete.
Assessed
Valuation
10
(3) __ 244_� lo`� o
.•.
� �
• - ivr •
(�) —
(8) �.3$fJ
- ACTION BY AUDITOR -
Homestead
Valuation
• ( j/�jjjjjj�
• �jj�jjjjj/