Homestead_Brown (23) STATE rORM!)w,R_r u-Ps r1EASU{FA FORM i}IA
�A r
IMPORTAN'TNOTICETOHOME STEADFPROPERTYOWNERS -za
Gibson County Auditor
101 N Main
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 ner for homestead fraud.Homestead fraud causes higher tax bills for all:therefore., --_ .
Ali— — ---- --- -— - - - -REA x344-2009 requires taxpayers who Finis:the homestead-standard deductioe m veiny t a ev re deltaic to receive the
benefit and to provide additional identifying information necassan'to allow county genemnrent to better monitor homestead
filings.'Ibis information will he kept confdemial 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.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
_ Brown, Madie Arlene
\\\N R3 Box 207 `L
Princeton IN 47670 l
924
Madie A Brown
706 E Emerson State Parcel Number Legal Description
PRINCETON IN 47670-1904 .
I11ttlltttlFllttI Ill IIIFlttllttttlttlllttttlltttII I I 26-12-07-204-001.031-028 019-01031-DO NS LOT1PTR3
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 i
Owner I First Middle Last
�iaie Art ch , /3 wn
long Address(number and street.city,state,and ZIP code) ['Same as property address
1 Ob 5 gilie1- 0,7 Pr,fly&#o,7 112 47126 >D —/C.-
,,
Spouse First Middle Las[
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as properly address
— Social Security Number(last 5 digits) Driver's License/Sate ID Number (last 5 digits) Other(please specify in Part 4 below)
Smre
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 li ble for back taxes and substantial financial penalties.
Ow Cr I Signature Date
•`
� } CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� State Fwm 5473 (R6I 1-03)
Presrrihed by the Department ol Local Govemment Finance
INSTRUCTIONS: See revcrsc side lor /ilinq insbucfions.
� - FORM YEAR
HC10
i '� +
I YT�
1. � �1 .a /' �`\
Ji � �
_ ,_ � •iny
I(We) /�,(..GAl�( I/ Wl�/1/Jk�.( 1/ J� /certify ihat on the 1 st day of March, 20_
I(We) occupied as our principal place of residence the following descnbed real property (or which a Homestead.Property Tac Credit is hereby daimed:
❑ I(We) owned ❑ Are buying under contract C''�S��,^! �� �
` Have a benefidal interest in the enlity Nat is liable for the property taxes on Ihe property and that owns lhe property or is buying under a wnVact.
If buying on conUaq. Fee Sunple owner's name
tonVattisrecorded
Toxnship
Tating aistrict (riry,
Record number � Page
Parcel number /'� Leg�L�¢y�% uo� �O � � Is rty in question:
�/� �J (0 3/'� / , / ��Realproperty ❑ �b�eHwno(/.C.67.f-n
H any portion ol Ne residential sW Gure or the land not exceeding one (t ) acra Nat immeEiatety wrtounds lhat swcture is used b produce incmne, describe Ne use and portbn
ot the properry utilaetl to prciduce income.
County
Tawnship
I hereby certiy the above sWtements are We, coved and wmplete.
city, §�e. 21P code)
Coun�y
Tavnship
`�+�'.a.'�_'-�'�'z�fc''.i�'^^�'' .,��''�' t ��. :`�TRUETAX� �., ASBESSED�VALUE �HOMESTEAD� NON:RES�DENTIAL„ ra
� . 'ASSESSO�S� LY.�a'�����'� yAI.UE��.sFyi. "FATa100%OF.(T7Vz �"��`VALUE.�� ��,��,��'�i:.�...._.. �� +� •y
��..,�...-,A n... .L VALUE: y��Sr.�
=�as, 3� ,a.c.s� s `�+1�
Land nol exceeding 7(one) aae immedialely � � .t�.� ,� ' ir �,,,,� u,r.
sunounding residential improvements. (� 1 ���t -.w ,. : !
. d�..k.�-`+.,'''�5��.'�`�.
�. �°
Other land (p� '� . y?� z. �"'f �
s�,.� �
Tdal land (line 1 plus line 2) (3)
� -`s� ,� ,�.�r.s hYi+s��i':"i
Dwelling (4) a� �'�! �,�!. ST�"
Residentiel improvemenb or Mnuatly ���`'' °"���'�'��
0.ssessed MohUe / ManutatLned Home Garage �5) x� .t�L���d ~:i:�����
o.-.s. � _'�.t�c'.��'�.._ `v�a i"
a�"-'.. � 'F� ' "
Oiher improvements (6) �:�
F'�k��
Tdal improvements (line 4 through line 6) (7�
Tctal vatue (line 3 plus line n (g)
I hereby certify fhe above is We, corred, and Signature olnssessor Date signed
complete.
Verifyiig aclion - Sig�ature of NidiWr Date signed