Homestead_Hayes e• {MATE fORMfa:M R-/EMI 1ILsSUtER FORM:S IA
ArPWWrD By AT IE NwPO Of M<1RL1i(ANA R.EXNBtD BY 11E DEPARTMENT OF LOCAL CM20.VMRII ra:.UCE,e 41.1-2211
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 N this deduction becomes
more beneficial-there is male incentive than e'er for homestead fraud.I lomestead fraud causes higher tax bills for all:therefore.
HEA 134-t-2IX6 requires taxpa.ers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional identifying information neces ry to allow county government to better monitor homestead
filing:,_ Otis information will he kept confidential and CM only be arrested by authorized county officials.The Depanment of
Local Government Finance will use this information to create ants that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
- Hayes, Michael J/ Barbara S
LIVED'
coon IN 47670
3957
Michael J/Barbara S Hayes
1904 S Main St State Parcel Number Legal Description
Princeton IN 47670-3408
I1IulI ullll'ul utlll ��nIullint1u 1t 11nninllu1ll 26-12-18-304-001.115-028 019-0111500 ROSS PLACE 12
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
icHAEL T E yes
g Address(number and street-city,state,and ZIP code) – — - ---- — Same as property eddies. –-
Spouse First Middle � Last
DIR�'l 4 �U-E l'[+ 74y s
Mailing Address(Number and street.city,state.and ZIP code) ®Same as propery 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 1 Signature ��\\ DEL,
, C1AIM F�t FI�"ES"1FAD PROPERTY TAX CREDIT FOR YEAR 19�.� _ - ,/
• , .,.,:...� . .
�. '. SEE BACK FOR F1 G 1NSTRUCTIONS D I�` 0`1 ��S' G p
I , `, � ) � �-a:�.�� � � : � : 4 oertify that on the let day of
h, 19 , I, . We as our nal place o resi.denoe the followirg descti)aed r�l
�eity o� which a. H�teac. Pzoperty Tax �edit is eby beirg claimad:
R��a':G : : -.�� �
Ir �"iB� � OWl18(��.��:._:. :r�w" • '
� 8IB Y�i.:,a�:'J�IPS'� WISCIBCt �-
p t,�,� 8�scsat �r.�st �►. r.r,� c�y�
Property Descriptia¢�. in -
Taxing Di.stTiCt 110wn. 7b�a�shiPi : �
Parcel thmter , -. or legal description stn�ar an tau statanent:
. � . �� o� P.� i�—
Oo�ty iC[.��Lti 7bwnsluP
�
If buyina on oontract: Ownera name (fee si�le owner)
mntract"reoosded in ReWZder's Offioe - Recaxd No. ' Page
If any portion af the residentisl etsucture or the land, nat e�eed.i.ng•one (1) acre that
iimiedlately stax'c�e th8t stZllCttae i8 used to p�so�ce lnoaoer de8CSlbe the use ei$ pCLtSC� of
the pzoperty t:ti].ized ta pxoduae 1r�come _
Pny other mtimties in which itdivldual owns ar is buyirig real pYOperty: �' Cb�: .. � Zbamship
�:.-F . ,
tl1B �tH[�:nt 18 tLUBr aoitect•aid oo[[Qlets. /�� .
,n i c � . .'1 H�� . �%i. lL i �0,. . ,ti� . �n .�, :. ��.... '. �..I�/!L�
� � � uLY,
•Individuai either owns or is buyi�g imes a oontract that pxovides he is t,o pay the
property, t�aes aa� the resi�oe, or has a beneficial intezest in the ta�yer..
, �.. .. . ,
• � � - FpR ASSESSOR�S USE.ONLY -
. 1Yt�e Cash: .
. � . . � - Value .
lard rot e�aoeedirg 1(o�e) acse iim�3iately �
Surro�u,ainy reasaet►r�a1, inpaovs�ts � .cl> �
Other Iand � ' (2)
7bta1 7and � • . . • • ' (3) ~ � '
Fesidential Iap2ov�nt8; p�j,nq ' (4) .
� Garage (5)
� . �� c6) � y SD .
otr,er �,t� c„ a o
'ib ' .L�uvva[�mts - Line (6) Plus (7) equals (B) (8)
I herei�Y certifY the.ahove is true� oozx�eet� arrl aa��ets.
�,nature o Aseessor
- ACTION BY A.UDIT(1R -
��enoved: —
P�ssessed �
Valuation .
:
S3o . --
,1
. . •� ` f
� - = . '.:'i
.��w =:,.
Date
�ate: _Q� .C. /9 %9�� _ .
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