Homestead_Leatherman -` • MATE FORM fl?(.IIL'r%AP) MASURER Po0.43IA
APPROVED BY STATE/UMW OF MYT k iNnS.:OM RFYAIBED BY mr DEPARn 4T{w LurAL rAvttNMEA'T FIANCE h'LI.I-S:-Itl
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 becomes
more beneficial.there is more incentive than e'er for homestead fraud.Ilomestead fraud causes higher tax bills for all:therefore.
0 HEA 1344-2009 requires taxpayers who receive the holnestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying infomcmon Tee's ry to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be accessed by authorized county official.The Depanntent of
Local Government Finance will use this information to create [ads that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
—. Leatherman, James E IlNickey I
724 S Main
Princeton IN 47670
2955
James E Leatherman II
724 S Main State Parcel Number Legal Description
Princeton IN 47670-2650
11111111111111111111111 I I 11111111111 11111 11111111111111 26-12-07-304-002.519-028 019-02519-00 PT SW 7-2-10.1485 AC
PART 2: TAYPAYF.R INFORMATION
Owner I First Middle Last
-�tg Address(rambc n:.d stnrc city;sane,and ZIP code) —p —/ — — — _2.Some as property address__ --_ ___-.._. -_ __
7rf S. Mc„2 St. / rincctr,. ZN. y74 -7v
Spouse First Middle Last
Vi c,k e y r e.r c. I_ea-liter nl4w
Mailing Address(Numbef and street,city,stale,and ZIP code) jiSame as property address
729 5. NI 4 I h Set Princeto+s- T N. 77670
PART 3:CERTIFICATION _
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
7
��� CLAIM FOR HOMESTEAD PROPERTYTAX
' CREDIT/STANDARD DEDUCTION
S f Sfate Fwm 5473 (R4 / 8-00) .
�a.
INS7RUCTIONS: See reverse side lor filing insWCtions.
1 : G 5� !.
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I(INe) �1�11�-�-2)% u l� p�0 a1� YJ �� �,��{y �at on the 1st day of March, 20
I(We) ocwp d as our prindpal place of residence the ' g described real property for which a Homestead Properry Tac Credit is hereby daimed:
,�1 (We) owned ❑ Are buying under contrect
�Have a beneficial interest in the entity that is liable for the property Wxes on Ne property and that owns the property or is buying under a contrad
If Duyiiq on conVact, Fee Simple awnefs name
Recordefs olfice where contract is recorded
County
.���
ramship
Legai desuiption
T�e�suicnary.
c-A_.��a
Record number � Page
It arty portion ot the resiAential s Wcture or Ne land rwt exceeding one (t) acre that irtunediatey surrounds that shuclure is usetl to produce irxame, describe the use and portion
ol Ue property u4Lzed to produce income. � -
' " ' '�^'-� � ?- �"'�.'; 'z s"STANDARD`DEDUCTION ALLOWANCE+-"�'` �a � ""�`H'�✓� �a`�"-� '
� :��=.y��'s'�:�+_. _�,?}i�x�: ������ �s`_u3 =,?:�. _�.`�`�.`�..� �.
20_Pay20_
Lesser of 12 Homestead
ValuaEon or b6,000 $
SignaNre of Auditw Daie si
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