Homestead_Hall (8) •
MATE FORM 5IN'ix:r}•MI TREASUtIR FOItY.131A
.APPROVED BY STATE&WM OFAIVax'.LT5.pare PRElllam BY nn DEART\4YT OF LOCAL novE VMrnl FINANCE a•VI.t-r-s.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead atandand deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud Homestead fraud causes higher tax bills for all:therefore.
ill HEA 1344-2004 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
filings.This information will he kepi confidential and can only is accessed by authorized county officials.The Depanmem of
Local Government Finance will me this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Hall, Ricky A/Michelle A
2204 N 10th
Princeton IN 47670
1594
Ricky N Michelle A Hall
204 N 10th State Parcel Number Legal Description
Princeton IN 47670-1128
26-11-12-203-002.505-028 019-02505-00 BMA 139
Ill1Fllt11lllllll1lllll IIIIIIIIIIIII II IIIIIIIIIIIIIIIIII
. PART 2:TAXPAYER INFORMATION
_ OwrySl ` Ce f Flrst h I ' o f Middle ip 1 ( Last
Kig Address tnumbe a s city;state,and ZIP code;— / O me pmp n�^IJ —
0 A/
� •
Spouse First Middle Last
Mailing Address(Number and street.city,state.and ZIP code) fq Same as property address
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 1 &ca Date 5 d� I C
0
•
. �.
YEAR
:y�� CLAIM FOR HOMESTEAD PROPERTY TAX FORM
�� '� CREDIT/STANDARD DEDUCTION HC�O
State Form Sa73 (R2 / S92)
° �a: �
INSTRUCTIONS: See reverse side !or liling instruMions. . }�
., !i7 T3��
.. . .. ,. �.^ .",.. ,. T,... , •-�.°;:CERTIFlCATtON_STATEMENT'" " . ;'°.="" ; : LL;<l�L
_ . „
�/ r....o 1�L//
I(We) �� � �t' cenity that on t�t `� t d� y of �March, 19_
I(We) occupied as our principa place of res' ce the following described real property for which a Homesiead Property Tax Cretlitis h� daimed:
�(We) owned ❑ Are buying under contraci � � � ��
'.� Have a beneficial inieresi in the entiry ihat is liable for the property taxes on the property and that owns ihe�prope.rEy-0r�is buying under a conlad�
:. -. . .�-� -. '� - � • .. CONTRACT RECORDED.. �. �.. -: : "'a,. � ' -' - -� -
.�.. .. . .. . : : --... �s: .. ���_ � : .: .r;,.. �
_ _, _ .
If buyirg on contraa, Fee Simple owner's name
RetOrder's oflice where coniract is retortletl Record number Page
Couniy Township
Parcel number Legal tle;
0
If any portion of ihe residential structure or the lantl noi
of the property utilized to produce income.
. e, ` - � . . - . . .
towq fownshrp) �
(t) acre tnat immediatety wrwSnds that structure is used to produce income, descnbe Ne use arid ponion
-�•�` ' ' � � � � ' � TRUETAIC -ASSESSED . MOMESTEAD NON-RESIDENTIAL. �
�-ASSESSOR USE ONLY ", , VALUE��� �VACUE, VALUE . VALUE � �
Land not exceeding 1(one) acre immediately � � - � �=
surroundingresidentialimprovements. (�) � � �`�� '
Otherland (p) � ae�°�
Total land (line 7 plus line Z� (3)
Dwelling (4) � �� " . ..' ` .
Residential improvements . . _
Gara9e (51 . -..
Other improvements (6) � .
Total improvements (line 4 through line � (7)
Total value Qine 3 p�s line 7) (g)
I hereby certify the above i5 irue, CorreCt, and Synature of Assessor Date signetl
compiete.
Ventyirg action - Signature oi Auditor Date signetl
.," STANDARD
19_Pay79_
Lesser of 7l2 Homesiead
Valuation or 52,000
5