HomeMy WebLinkAboutHomestead_Davis (11): Gibso� County Auditor
101 N Main
PRINCETON IN 47670
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nt.�suun wad �-�n
lndi�idua� and rtu:riN couplo are Iimiied �o ore homeaea0 �unAaN AeAu.�ioa As the receipi of Otis deduc�ian becmres
merc beneficial, tMe is mwe incenmx tlun e�rr for homt>rcad fraW. Homesead faud causes hi�hn �ac bills (or all: themfue.
HEA 1337-?W9 requim uxpa.m wlw reccire Ihe tames�rad sundarJ JNuction in .zrify tlut �6ey art elicible �o rtcene ihe
brnefii snl ro p�a'ide addi�ioml identiicinp informatiun neee.'vrr ro allw.� counrv ro.'rmmrnt ro betrer monimr homatzaJ
filin�. This inforrtulion x�ill he l.ryv ronlidauinl and can onl�� kc attezcnl M1.' authorveJ rouNy nflfcials.lTe Ikpanmem nf
Local Gorertment Finane< ��911 u.e this infurmacion to creau �wls tha� �eill h;in �O' ��+als dimiwm ipme>ICaJ fraud.
1161
PrincetonlN 47670-2528
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Taapaeer Name Propertc AJdress
606 S Slomwnt
Princcton IN d7670
State Parcel Number Leeal Description
k 26-12-07-404-000.590.028 019-W59o-a0 KOLBS n�D 23
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.
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Social Stturiry Numbcr Qan 5 digits). DmcYs Lirensc/State ID Nwnbcr (last 5 digits) Othcr (plcasc spccify in Pan 4 Mlox�)
Smrc
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Each undersicned certifies, under penalry of pequry, that the above and foregoing infonnation is we and correct and that he or she is elieible to
receive the homestead standard deduction on this propeey. Each undersi¢ned al;o understands thxt, by claimine additional homestead deductions
unlaufiully, he or she may be liable for back taxes and substantial financial penalties.
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 54�3 (R2 / 592)
GIBSON ;�;��;r.;7Y AUDITOR
❑ Have a beneficial interest in the entiry that is liable for the properry taxes on the property and that owns the property or is buying under a coniract.
CONTRACT RECORDED
It buying on conVac6 Fee Simple owners name .
RecorAers oflice where convact is recorded . Record number Page
PROPERTY DESC N �
Counry .. Township 7az' g� in t(qi . rownship) -
,pp�mbey� O � ,�� Lega1 tlescripUon
U U
If any ponion of the resitlential structure or the land not exceeding one (t ) acre that immeGarey surrounds thai structure is used to produce incwne, describe the uu and ponion of
Ne property ulilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Counry Township
Signatur daimant
ereby certify the above statements are true, correct and complete.
Address(numberanOSfreet iry,sfate,ZlPCode) �
�oG S � .�L • �F76 7 0
ASSESSOR USE ONLY TRUE TAl( ASSESSED HOMESTEAD NON•RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediatety (� �
surrounding residential improvements.
Otherland (2)
Total land (line 1 plus line 2J (3) '
Dwelling (4)
Fesidentiai improvements
. Garage (5)
Oiher improvements (6)
Total improvements (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true, correct, and Signature oi Assesor Date signed
complete.
Verifying action - Signamre of Autliror Date signetl
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead . �
aluation or �2,000
Signature of Auditor ate igned _ Q