Homestead_Harbison (7) SIAIE FORI!,tn.R/w'1 nRrAW.ra MIN TS-IA
APPRLA'ED BY'LATE BOARD OF AM-ANTE.-`n,N PRE4FIBED BY t 11L DEPARTMENT OF LCEAL GOVEANNIM7 FINA.NCEMV1.13'4.l
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple. are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
ILEA 1333-2009 require 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 be kept confidential and can only be accessed by authorized county officials.The Department of
Local Goverment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Harbison, Sandra S/Jean F
934 S Gibson
Princeton IN 47670
1171
Sandra S Harbison
701 S Stormont State Parcel Number Legal Description
PRINCETON IN 47670-2730
111111111111111111e1,111 Illtttlf tlltlltttll 11111111 26-12-07-404-001.710-028 019-0171410 KOLBS ADD 7
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
SA V� f- /-t•r} Shc e n r b i 9 0 o
•ng Address(number and sneet,city,state,and ZIP code) n Same as property address
Cs-k-~)O 1 Soc - tn. -tcorinoh-r Pbt' h Petorllg(-., ; to:, ,3- L1767b -2730
Spouse First Middle Last
Mailing Address(Number and street,city,slate,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)
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
•
� } C�AIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� Sute Fwm 5473 (R6 / 4-03)
Prestribed by l�e DepaNnent of Local Govemment Finance
INSTRUCTIONS: See revcrse side Iorlling instmc(ions.
FORM YEAR
�-� lHC10 . -^�1�
, d �
� g J�....' '— %`
: 1
I. ! L� /i (
� M�e) u � certiry thaaon�the 1st day ofMardil20
.t/�C�v.�✓tiiyTY,_ ,,.,.L,� —
I(We) occupied as our prindpal place oi re i nce the follmving desaibed real pmperry for which a Homest�ad,P�ropeity�TarCredit is�bereby daimed:
❑ I(VJe) owned ❑!ve buying under coMract
`Have a benefidal interest in the entity ihat is liable (or ihe property taxes on the property and ihat owns the property or is buying under a wnVaU.
I( buying on conirad, Fee Simple ownefs name
RemNers olfice where wnVaq is reoordetl
County
Toxnship
1 ���' �� U �i � �\v lw/!.N✓'��
portion ol Ne residential sWCWre w Me Wn not exceeding one (1) acre
properry uti�ized b produce income.
Counry
I hereby ceAity the above
Addreu (number aM street
Tavnship
Land not exceeding 1(one) aue immediatety
surtounding residential Improvements.
Other land
TUaI land (line 1 plus line 2)
�
Dweiling
Residentiel fmprovemenh or MnuaOy
0.ssessed MobOe / MamAaQUred Hmre Garege
Other improvemenis
Tdal improvements (line 4lhrough line 6)
Tctal value (line 3 phs line �
I hereby ceAify ihe above is We, corred, and
complete.
V�lying aclion - Signature ofNiditor
20_Pay20_
Lesser of 1/2 Homestead
vawanon or 535.000
Signature of NMew
�
i�)
�2)
(3)
(4)
(5)
(6)
(�)
(8)
Signature ofAssesmr
Recard number � Page
Tating district (city, town, fownshiP)
Is ihe property in question:
❑ Real pro0erty ❑ Mobile Homo (I.C. 67.7-7)
iatety surrounds that swcture is used to produce income. describe the use and portion
5
Date 5igned
Dale signed