Homestead_Johnson (13) •
STATE FORM 5tt jc'/*-0.1 TREASURER FORM 11A
APPROVED IRIPORTANTnNOTICETO HOMESTEADrP PROPERTY OWNERS
Gibson County Auditor
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to or homestead svndani deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HE.\ 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifvinc information necessary to allow county government to better monitor homestead
filings this information will be Sep confidemial and can only he accessed by authorized county officials.The Department of
local Government Finance will use this information to create touts that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Johnson, Robert M/Jowyn B
403 N Race
Princeton IN 47670
906
Robert M/Jowyn B Johnson
403 N Race State Parcel Number Legal Description
Princeton IN 47670-1735
H1111111 26-12-07-203-003.022-028 019-03022-00 NS LOT 3 PT R1
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 11 1. First / Middle T I Last
oBerl Atr('Aae� �JO so
au Address(number and street,city,state,and ZIP code) B-5ine as property address
Li 03 N ace St"
First Middle Last
701,-.1yP) efh JaLsal..
Mailing Address(Number and street,city,sate,and ZIP code) a as property address
4/0 3 N pace .Sf L�J
•
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
e%��� .
a q CLAIM FOR HOMESTEAD PROPERTY TAX
a��� CREDIT/STkNDARD DEDUCTION
�:;�� Slate Form 5473 (R2 / 5-92) .
�su � , �
INSTRUCTIONS: See reverse side !or (iling instruc�ions.
� . . � � � ' - _ - - CERTIFICATIf
" FORM YEAR
HC
A
���we) 1„{„JY> t" ) �[J (fiJ ��� C/ certify�tt�e6tt�7 f ch, 19�
���occu i d as our principal place of residence the following described real erty for w- h a Homestead Prop2rty`%fx��(�,�( :: S!) ""
C�.riwe) o ed ❑ Are buying under comract . . . �ROR
❑ Have a beneficial inreresi in the entiry that is liable for the property taxes on the property and ihat owns the property or is buying under a contraci.
- � - � CONTRACTRECORDED � � " . �
It buying on contract,�fee Simple owner's name .. _- .. ' - .
Recortler's oflice where tontratt is recorded Record number Page
Counry .. .
Parcel number �
�l9-�
If any portion of the
of the propeny utili:
ro
- � PROPERTY DESCRIPTION � � � �
' 7ownship � - � Tazirg dist ( � , w/�, fownship)
- � Leqal description ' .
� _ .
structure or the IaM not ezceeding one (7) aae that immediatey surrounds that swciure is usetl to protluce income, desaibe ihe use and ponion
ice income. . I i .
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES �
Counry Township County Township
�by cenity the above statemenis are true, correct and complete. Sig r iman�
Address (number and streeC ciry, sfafe, ZIP cotle)
ASSESSOR USE ONLY TRUE TAJ( ASSESSED HOMESTEAD NON-RESIDENTIAL �
VALUE VALUE VALUE VALUE
Land not exceeding t(one) acre immediately . �
surrounding residential improvements. (�) -
Otherland (2�
Totai land (line i plus line 2� (3�
Dwelling (4)
Residential improvements
Garage (g) ��
Other improvemenis (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line 7� (g)
1 hereby certity lhe above i5 irue, correCi, and Signature of Assessor Date signed
complete.
�=�'virg action - Signature of Audiror Date signed
79_Pay19_ I
Lesser of 1/2 Homestead
Vaivation or 52.000 S
ol Auditor