Homestead_Hensley Stitt FORM!)'M iRU T-NI MP ASI:LER FOLM:}IA
' - • AITRtwEO BY STATE BOARD Of M- *INR._v+ PL,mm BY mr DEPARTMENT OF LOCAL GOVEILVMETT FINANCE re-1.1-2:4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sundatd deduction.As the receipt of this deduction becomes
es
more beneficial,there h more incentive than net'for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information necessary to allow county gosemment to better monitor homestead
filing; This information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY C\FORMATION
Taxpayer Name Property Address
R4 Box 294
Princeton IN 47670
2498
420 S Richland Creek Dr
Princeton IN 47670-9570 // State Parcel Number Legal Description
IIII IIt tI IIttI Illttd I I 1 11111 I Ill ��,� 26-11-14-200-004.289-028 019-04289-00 PT NE 14211 .34 AC
,
Spouse First Middle Last
timis
'Willa-T..dl ress(Number and street,city,state,and ZIP code) ❑ Same as propert_ address
-
•
.1 �_____LTitYZnZIl�► 1 — C
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.
iir
FORM HC 1� 1479
heuriEeO By SWte BoarE of Tax Commissioners
To & FiIM in WD���te
CLAIM FOR HOMESTEAD PflOPEATY TAX CREDIT FOR YEAR 19 � 9
SEE BACK FOR FILING INSTRUCTIONS
,(We) �r`-Q'iU-�-��� certify that on the 1st day of
March, 19 � I, (We) ccupied as our pri cipal place of residence the following escribed real property for
which a Homestead Property Tax Credit is hereby being claimed: Q/� n���JQ �v5
v Q / • 6.t:.%
I, (We) ❑ owned
❑ are buying under contract
� have a beneficial inte e t in the taxpayer
Property Description in ��� County ��2-a--� Township
Taxing District (Gi�y—Ta�Fl, Township): ���
Parcel Number or.legal description shown on tax statement:
�°� �IJ E ��� /�f- a - i � ( �G .a )
If buying on contract: Owners name ��� sim0�e o.�e��
Contract recorded in Recorders Office - Record
If any portion of 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:
�hereby certify the above statement is true, correct and complete
County Township
ana
' 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(one) acre immediately
surrounding residential improvements
Other Land
Total Land
�"' k 1 �' ��
� r�-�
Residential Improvements
,�� � } 19�elling
Garage
Other Improvements �i'i .� /� To
T�Improvements - Line (6) plus (7) equats (g�UDITOR
I...,reby certify ihe ab�e is true. correct. and complete.
Signa:ure ol nsseswe
True Cash
Value
(t) � 3 c
(2) —
(s) a 3 0
: (a) / s�� 80
(5) —
(6) /5�b 8 0
(�) �
(8) /�G fr o
- ACTION BY AUDITOR -
Assessed
Valuation
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Date
Date:
Homestead
Valuation
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