HomeMy WebLinkAboutHomestead_Burns (6) .. • SIAM FORM!Mo.IR U•wt TREASURER K AN:SIA
AIIRtw'ED BY Mar YHRO OF ACCOU TS.9x PRESCRIBED BY THE DEPARTMENT OF LOLL GOVER,AltliT FINANCE HCw-rat
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 mar for homestead fraud.Homestead fraud causes higher tat 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
filinLp.This information will he kepi 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
Bums, Doyle E/Patsy A
701 E State
Princeton IN 47670
931
Doyle E/Patsy A Burns
701 E State State Parcel Number Legal Description
Princeton IN 47670-1911
ltittlitttltlltt�ttt��� Intl 'Itlulll ��tr��t� X 26-12-07-204-002.509-028 019-02509-O0 ARCHERS ENLG 9 PT
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
Owner I First Middle Last
PAT-5.-`1 R vBRNs
'ling Address(number and street,city,state,and ZIP code) Li Some us property address
7 0/ E r r 7 PR i n/C e.mr►/ XA/ q76 7o
Spouse First Middle Last
Mailing Address(Number and street,cily,state,and ZIP code) ❑ Same as property address
_ Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify'in Pan 4 below)
Sae
PART 3:CERTIFICATION - - - j•i - —--
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
,..�•..
e� "°q CLAIM FOR HOMESTEAD PROPERTY TAX
���� CREDIT/STANDARD DEDUCTION
:�.;� Sute Foim Sa73 (R2 / 5-92)
uu
INSTRUCTIONS: See reverse side /or liling inst�uctions.
FORM YEAR
� HC70 �
a
�' ""�e) ��.� ������L/�iL_,�i ��7 __��jr'��f� i�i t �.the- t� March. 19 .�
) occupied as y r pnncipal place of residence ihe3 lowing described real property for which a Homestea F���r �7�Rr i is hereby claimed:
�/' /
� I(We) owned ❑ Are buying under contraci • _
❑ Have a beneficial interest in ihe eniity thai is liable for the property taxes on the property and thai owns the.property or is buying under a contract.
' i r . _
' CONTRACT RECORDED = � - � .
It buying on coniract, Fee Simple owner's name - . - ' . .
Counry
Parcel nu e(
If any portion ot e resid
of Ihe property ulilized to
Township
� or the land not
ie.
PROPERTY DESCRIPTION
. Taxing tlistrict �
6
6 �
number I Page
fawnship)
that swcture is used to produce income, descnbe the use and portion
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township Counry Township
�— '—�
, y certify the above statements are tme, correct and complete. Si nawre �aiman� �����
Address (numberarrdstre , dry, sta , ZlPcode) �
ASSESSOR USE ONLY � , TRUE TAX ASSESSED HOMESTEAD . NON-RESIDENTIAL.
VALUE VALUE. VALUE VALUE ,
Land noi exceeding 7(one) acre immediately
surrounding residential improvements. (�)
Otherland (z)
Totalland Qine 7 plus line 2� �g)
Dwelling (4) -
Residential improvements .
Garage (5) � . ..
Other improvements (6) .
Total impmvements (line 4 through line � (7)
Total value (line 3 p�s line � (g�
I hereby Certify the above is true, corrett, and SignaWre of Assessor Dare signed
complete.
'-g action - SgnaWre of Autlitor I Date sgnetl
L
19�'3 Pay 79 ��({
Lesser of 7l2 Homesiead
Valuation or 52.000
S
Autliior I "a' �s'9�� � �3�
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