Homestead_Johnson (7) MME FORM!J%r,R:/•YI TREASLUUR FORM TB-IA
.APPROVED BY'MATE BOARD OFMYR,\T5_},r PtI*RIBFD BY THE BEPARTI NT OF LOCAL rAVERMMF T FINANCE IC 41.1-_a1
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 of this deduction&tortes
more beneficial,there is more incentive than es er for homestead fraud Homestead fraud causes higher tax bills for all;therefore.
1114\ HEA 1343-2109 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 be kept contTdentinl and can only be accessed by nuthnrieed county officials.The Ikpannmnt of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Johnson, Donald/Patricia
1807 Outer S Main
Princeton IN 47670
3897
Donald/Patricia Johnson
1807 Outer S Main State Parcel Number Legal Description
Princeton IN 47670-3405
26-12-18-300-001.366-028 019-01366-00 BROADLEIGH PARK 14/15
ti,II toIt II aI nt III II I m III rutI r I r II r I tar II tar II
PT
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
n4 Id b. l�,�¢)�D�AD s orb
tg Address(number and strceL city,sttate,and ZIP code) - - — - -_ (SemeTa property address — — — — — -.--
/kO7QvM 55F 0111 SL /(Prthc�yTU uTJ6-70
Spouse First Middle' Last
,y�YICI+4
A . , � 7phhSo/t
Mailing Address(Number and street,city,state,and'LIP code) l4 Stme.as property address
/ZO17 aka'$ • iM1Ih St . ?rtn?oeI 19Th 14%7D
Each undersigned certifies,under penalty of perjuy,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
We •
WflM ML 10 1979
PrescriDeE By Siate BoarE ol Tax tommissioners
To & FiIM in DupliWte
CLAIM FOA HOMESTEAD PROPEATY TAX CREDIT FOR YEAR 19 7�' ,/
SEE BACK FOR FILING INSTRUCTIONS p�q - 0/3 6 6' ��
�� �.,iLGl1-ci.Q..C.�- S`G `7"Q.�itA,r
(We) -«4��--Q-e�--- certify that on the 1st day of
arch, 19 � 9 I, (We) occupied as our princi al place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) C� owned �
❑ are buying under contract
❑ have a beneficial inter st in the taxpayer
Property Description in � County ���n Township
Taxing District (City, Town, Township): "'P��1�-� �M�--����
Parcel Number or legal description shown on tax statement:
�.c�t.cc�u.:,�., `�ct�. / �G t /Sn/''L
If buying Ofl contract: Owners name ��� simple owner�
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:
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 i�rov�emenis � �
Other Land ��
Total Land
Residential Improvements J��j�� � ;+ !�r3 Dwelling
Garage
� , ���.���al
Other Improvements � AUDITOR
TC�lmprovements - Line (6) plus (7) equals (8)
I:�oy certify the above is true. correct. and complete.
Signawre_
True Cash
Value
(�) /6%
(2) �
(3) /6�a
(4) /�}�B—
(s) /lo-/�'riFi
(6) /,�
(7)
ca� �
Assessed
Val��
O
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��
—�1.'
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S-
Da;e
- ACTION BY AUDITOR -
Date:
Homestead
Valuatio Q