Homestead_Hicks (3). SIAM Forst,e.10C1 5..1 TREANIEA FORM 73-IA
Arratn'ED BY SLATE BelARO OF LOOMS.W PRFSCTJBID BY THE DEPARTMENT'S tfR:r.rtoBRYMrl.l rRN\CE tee-u-r-t.l
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sanded deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.I lomestead fraud causes higher tat bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to receive a the
benefit and to provide additional identifying information necet. ry to allow county government to better monitor homestead
filings.'Ibis information will he Leo confidential and can only he accessed by authorized county officials.The Depanment of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Propery Address
Hicks, Paul S Jr/
915 E Ohio St
Princeton IN 47670
1370
Paul S/ Hicks Jr.
915 E OHIO ST State Parcel Number Legal Description
Princeton IN 47670-8700
Itlttlltttltiltt'tot'lllltlltltlrtt'lltttll IIIIIIrtltltl 26-12-17-103-001.214-028 019-01214-00 PT NW 17-2-10.45 AC
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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 A u� First s�4t,E f Middle F' ' /_ Last
g Address(number and street,city,state,and ZIP code) , Same as property address
' 1.5/1Q4{t0 9- .JCkc1,A)7 �r 't%�`tw
_ _ - - ----- _--
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is taste 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 l ( ` Date /�
0
sE. R.n
°, CLAIM FOR HOMESTEAD PROPERTY TAX
�; �� CREDIT/STANDARD DEDUCTION
��;� S�atePOrm5473�R2/S92)
�m
INS7RUCTIONS: See reverse side lor /iling instructions.
FORM YEAR
ae+,o� �-
Ji !1 � ..�a �
I(We) . \ I ( 1�� �,�,(`� certify t'a"t n the tst-day�o4(Mar�� 19. :.
i-.i� r, � v�-- -v —
I(we) occ�as our principal ptace�of residence ihe foil v ng escribed real pmperty tor which a Homestead P,rop�rty;7ax�C�edit_is-hereby ctaimed
'� I(We) owned ❑ Are buying under contraci
�-lave a beneficial interesi in the eniity that is liable for the property taxes on the property and that owns the property or is buying under a Contraci.
" CONTRACT RECORDED ' - -.
It buying on conVact, Fee Simple owners name
Recorder's ottice where wntract is recortled Recortl number Page
County
� � PROPERTY DESCRIPTION . - �
Townsttip Taxing district (cdy, fown, township)
Parcel number Legal tlescription
� �q-�ia ��I-a� �
I� any portion ot the resitlential strucmre or the larid not eaceeding one
of the property utilized to produce income.
�, Y�l ul I'�-d-1 D,�S f'� �
aue that immediatety 5urrounds ihat siructure is used o produce income, descnbe the use and portion
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTtAL
- VALUE VALUE VALUE VALUE
land not exceeding 1(one) acre immediately � .
surrounding residential improvements. (� � . '
Oiherland (p) -
Total land (line 7 plus line 2� (3)
Dwelling (4) � �
Residential impmvemenis �
Garage (5) . � -
Other improvemenis (6) ,
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line � ' (g)
I hereby certify ihe abOVe iSlrUe, COrrecl, and Sgnature of Assessor Date signed
complete.
Veritying action - SignaWre of Auditor . Date signed
. STANDARD DEDUCTION ALLOWANCE
19 Pay19_
Lesser of 1@ Homestead �
Valuation or $2,000 S
Synature of Auditor Date signed