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Homestead_Lloyd (11) S It Fata l WIR_'a-N1 kTRFAS5URiIRM 71-IA a IMPORTANT NOTICE TO HOMESTEADrP PROPERTY OWNERS zJ Gibson County Auditor 101 N Main PRINCETON IN 47670 Individuals and married couple are limited to one homestead standard deduction.As the receipt of this deduction becomes more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore. IP HEA 1344-2700 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©n only he accessed by authorized county officials.The Dcpannlent of Local Government Finance will use this information to create tools that will help camp officials eliminate homestead fraud. PART I: PROPERTY INFORMATION Taxpayer Name Property Address Lloyd, Carl Frederick 130 S Jefferson Princeton IN 47670 1260 Cad Frederick Lloyd 130 S Jefferson State Parcel Number Legal Description PRINCETON IN 47670-2220 26-12-08-301-001.637-028 019-01637-00 HIGHLAND HOME 55 lIlttlltttltllttltttllltttttItlttltlttit1l1 litllrttltttll 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 CPRI F z4ayo lip g Address(number and street,city,state,and ZIP code) ` ' Same as property address l30 e 5. .1CFFCRS°n/ Nei' r'c(fa / Tr) tigo7a Spouse First Middle' Last Mailing Address(Number and street,city,state,and"LIP code) ❑ Same as propeny address Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Pan 4 below) sus _ _ ___ 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 S • 1 wArn xc m �s�v Prescri0ed By Stak Boara ol Tae Commissioners CLAIM FOR HOMESTEAD PROPERTY TAX CAEDIT f0A YEAR 19�� To & FiIN in Wplicate ✓ SEE BACK FOR FILING INSTRUCTIONS p�g _ Dl(�37- oa �(We) C „ �/(� ��(�- �J certify that on the 1st day of rarch, 79�, I(We) occupied as our principal place o residence the following described real property for which a Homestead Property Tax Credit is hereby being claimed: I, (We) .� owned . ❑ are buying under contract O have a beneficial interest in the taxpayer Property Description in County ��"� Township Taxing District (City, Tewr�-Tnwas#�ip): �;��;�� Parce� Number If buying on contract: Owners � or legal description shown on tax statement: ` e s s� T ' (fee vm01e owner) Contract recorded in. Recorders Office - Record No. Page 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: �hereby certify the above statement is true, correct and complete. / 3 G 1', AOdress County Township Ci�y. Sta�e ena Zip Coae 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 improvements Other Land � � � � � Total Land Residential Improvements �; � � � � 1g?�jDwelling ��r� �., - G,�arag_e " V 1 � r/ �� C� Other Improvements � AU�ITOR T' Improvements - Line (6) plus (7) equals (8) I�oy certJ.y,he above is true. correct. and complete. SigndWre oi Assessor Approved True Cash Value c�) ,/ 3S o (2) — (3) / .3 -S O (4) �—� (5)71%0 3-�� (6) S-�a��1 O (�> — - ACTION BY AUDITOR - • Assessed Valuation yLs o 4LS-O � — %�� j6 70 Homestead Valuation 4Cs o :� .��s �i- �.o -�y Da:e Date: �