Homestead_Johnson (9) _ STATE Inns:wee(R_1 f+rn TREASURYS FORM 75-SA-. APPROVED BY SIAIE WIAROS*AtT INT[by PRI.ATUBEW BY THE OEpARME(r(i LOCAL rOVELNMrNT FIANCE IC 6-1.1-1:4
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead s andard deduction.As the receipt of this deduction becomes
0 more beneficial.there is more incentive than mgr for homestead Irani homestead fraud causes higher tax bills for all:therefore.
FIFA 1344-2000 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 confidential and can only he accessed by authorized county officials.The Department of
Local Government Finance will sex this information to create Weis that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Johnson, James E/Twyla G
2004 Taylor AVE
Princeton IN 47670
1241
James E/Twyla G Johnson
2004 Taylor AVE State Parcel Number LeEaI Description
Princeton IN 47670-3208
26-12-08-204-002.551-028 019-02551-00 DIKE ENLG 12 PT/13 I t I II It II uI ser III II nr I t III t I n It II I u II t I HI
_ _ _ _ 9999_ _ _ _ __ \ _ ___.. __.
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
Cam as E . \Johnson
�re Address(number and street,city,state,and ZIP code) acme as property address
x004 la_yIo ( Ave TRince"on = V, 1-17670
Spouse ' �7 First Middle 0--0 {I�x t/� Last
TW I R \l 1 . 1 I t� S O ' 1
Mailing Address `'umber and street,city,state,and ZIP code) De‘me as property 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 I Signature Date
ID
s.a �''� � CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
~ �� State Porm Sd73 (R2 / 5-92) � '
iaTi . ; . •
_ INSTRUCTIONS: See reverse side (or liling instructions.
STATEMENT,
FORM
HC10
I�',
`^�� �/( V��` �\/l�l.l_��� I1 vV r�6L.t7V�� certity ihat on�the 1si day of March, 19_
) oc ied as our principal place of residenc h following de c ed real pmperty for which a Homestead Pmpe�z�Gr�s reby daimed:
t •. e
� I(We} owned ❑ Arebuyinq under cont t - y
A.
� Have a beneficial interesi in the entity that is liable for the property taxes on the property and that owns the property o� ie buymg u , act.
- � CONTRACT RECORDED � � -
If buying on comrad, Fee Simple owner s name � � , •� - • , •
AUDITOR��
Recortler's ottice where wmraci is recorded � Recortl number Page
County .I Township
�Gel r�e= — / �/1 I Legal de:
r /I �C/V
� any rtion ot ihe residential strucmre or Ne lantl not
ot the propetty utilizetl ro protluce income.
County
Township
PROPERTYI
� � . /� C_S�_ .
one (71 acre thai immediately surmunds that stry wre s used to
(
BV CLAIMANT IN OTHER COUNTIES
��by cenify the above statements are true, correct and complete. j[
��
Atltlre� O O er antl s7reel, fiy. state. IP wde) ,/�� ���
7 7 %7
ASSESSOR USE ONLY
Land not exceeding 1(one) acre immediately
surrounding residential improvemenis.
Otherland
Total land (line 7 plus line 2�
Dwelling
Residential improvements
Garage
Other improvemenis
Totat improvemenis (line 4 thiough line 6�
Total value (line 3 p�s line 7�
I hereby certify the above is Irue, correct, and
complete.
�•inn aaion - Sionature of Audiror
79_Pay19_
Lesser of 1/2 Homestead
Valuation or 52.000
TRUE TAX
VALUE
(�)
lzl
(3)
(4)
(5)
(6)
I�)
(8)
Signamre of Assessor
STANDARD
5
y
ASSESSED ( HOMESTEAD
VALUE VAIUE
antl ponion
NON-RESIDENTIAL
VALUE
Date signed
Date signed
��,�. � ���,�� � � �� • i