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A/PROVED DI MATE DIWOOf MMINTS.21vw PIESAtam By MI DrPM14ETfOF LOCAL rawEINSIMr FINANCE M•4.1='a.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than evcr for homestead fraud.Homestead fraud causes hither in bills for all:therefore.
HEA 1344-2009 requires tatpafers who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information n'cefsan'to allow county government to better monitor homestead
filings.ibis information will he Lein conlidemial and can only be accessed by authorized county officials.The I)eparintent 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
Gorman, John/Mary Ann
_ _ _ _ 1316 Darwin Avenue
Princeton IN 47670
1754
John/Mary Ann Gorman
1316 Darwin Avenue State Parcel Number Legal Description
Princeton IN 47670-2816
lllltllltllllltllttllll Ilttllrlllltll 26-11-13-204-000.981-028 019-00981-00MCKAW SUM 63
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PART 2:TAXPAYER INFORMATION
Owner 1 First Middle Last
gAndress foam d sneer city.state.Eiti ZIP-din-6y _ pioNny- -- - __
Spout (( �r First - Last
Mailing//,Address(Number and street.city 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)
smr
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
FOflM HC 10 1979
Prt5[ri�ea By Staie Boa�O ol ia� Commissioners
To Be Filetl in DuDliwte
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19-22 �
SEE BACK FOR FILING INSTRUCTIONS D�9' ODQ p��Qa
�(We) ��^' �%����L ((a*� � certify that on the 1st day of
rAarch, 19� I, (We) occupie as our principal place of residence the following described real property for
which a Homes[ead Property Tax Credit is hereby being claimed:
I, (We) C3'owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description
Taxing District (City, Town, Township): `�-
Parcel Number
If buying on contract: Owners name ��� simoie owner�
�� Township
or legal description shown on tax statement:
`�i'Yl c ,�cc,�.�.� !a 3
Contract recorded in Recorders Office - Record
If any portion oi 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
hereby certify the above statement is true, correct arid complete.
� l ��6_?d
I � �! 7�
� ! � l(0 � (,i�—. �e�'l�cti� —. �c
a re Stteet Aoaresa Ciry. Sca:e antl ZiD Coae
' 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 -
Land not exceeding 1(� a� immedia� �
1 s`urrounding residential i ov entt�
Other Land
Total Land _I�t� � 0 �979
Residential Improvements Dwelling
'� t , r
/���c./i�2t�a9e
AUDITOR otal
Other Improvements
T�Improvements - Line (6) plus (7) equals (8)
I._.�by certify the above is true. correct. and complete.
Assessor
App
True Cash
Value
( � ) S'o-u
(2)
(3) ��u
(4) �'i"8
(s) los�°�
(6) �..Z..�c—
�7)
(8) �-�70
- ACTION BY AUDITOR -
Assessed
Valuation
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Homestead
Valuation
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