Homestead_Madison xlNE FORM!MfgOCI✓.nl fRF•NREA FORMZIA_
APPROVED IMPORTANT NOTICE TO HOMESTEADEPROPERTY OWNERS t I
Gibson County Auditor
101 N Main
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 net for hom Lead fraud.Ilomestead fraud causes higher tax billss for all:therefore.
JI�L.J. HEA 1344-_000 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing,,.This information will be kepi confidential and can only to accessed by authomed county officials.The Department of
APR8 ZU IU Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORDIATION
7y /e Taxpayer Name Property Address
GIBSON COUNTY AUDITOR Madison, Lionel A/ Donna S
126 S Stour
Princeton IN 47670
1080
Lionel A/Donna S Madison
126 S Stout State Parcel Number Legal Description
Princeton IN 47670-2213
f I o t I I II n II I I II a II I 26-12-07-402-000.378-028 HIGHLAND HOME 1 PT/2 PT/3/PT/4 PT PT
nu
r u nt r u ur g r ut ut t t to SE7210.23 AC
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 l Last
Al/Dn/e/ f9-//r t/ 4144 roll
gin Address(number and street,city,state,and ZIP code L7 Same as property address
LZ4 SIc ca r //e/Nee 71-0,x-, 1 n/ 4671 7.0
Spouse First Middle Last
—7.--)0/4—)/shin S/._C-- *Ac, st J
Mailing Address(Number and street,city,state,and ZIP code) r'Same as property address
� LJ
/v?li S—/o%c! 4/A.)c e To.J ._L t..1
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
,..^•..
a/ _' °g CLAIM FOR HOMESTEAD PROPERTY TAX
���'' CREDIT/STANDARD DEDUCTION
;,��,=��� Sta;e Form Sa73 (R2 / 5-92)
�iii
INSTRUCTIONS: See reverse side !or tiling inswctions.
STATEMENT
FORM YEAR
HC
�_._ _
I(We) bf{�O'{�lQ,,,! ��7(%Vj!��.�� �[Q'(��(`/yl�__ rtify th t on ,he day o ar , 19_
I(We) occupied as our principal place of residence the following described real pmperty for which a Hom � ��� e claimed:
' GIBSON C U
n I(We) owned ❑ Are buying under coniract �
�iave a beneficial interest in the entiry ihat is liable for ihe property taxes on the property and that owns the property or is buying under a contraci.
- - CONTRACT RECORDED - -
If buying on comract„Fee Simple owner's name � � . . . � . .
Recorder's o"ice where contract is recorded Rewrd number Page
Counry
Township
Parcel n� er ' legal de:
�3��-�
tl any pomon ot the residential strucmre or ihe lantl not
of the property utilizetl to protluce income.
PROPERTY DESCRIPTION
Taxirg distritt (city. town, town5hip)
On_,-. e/I_- - /
� ont,+(U acre ihat immediaiely✓sGrrounds ihat swcWre iSred t
-�P�7-�-�o,a�
antl
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Caunry Township County Township
I hereby certify ihe above siatements are true, correct and complete. Signamre of claimam
ess (number and streeG ciry, state, ZIP co0e)
�ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
� VALUE VALUE- VALUE VALUE
Land not exceeding t(one) acre immediately
surrounding residential improvements. (��
Otherland (p) '
Total land (line 7 plus line 2� (3)
Dwelling (a)
Residential impmvements ,
Garage (5) �
Other improvements (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line � �g)
I hereby certify the above is Uue, correct, and Signature ot Assessor Dare signed
complete.
Venfying action - Siqnamre of Auditor I Date signed
STANDARD
19_Pay79_
Lesser of 1/2 Homestead
Valuation or 52,000
�
SignaWreotAuditor �/ n y 1 7 J... 0 Fl � luai��
�r�