Homestead_Mason (19) 'MATE,ORM!!'rolle 1v0.1 MPFASU HA Po0.N 73-IA
.VrR(A'Enm'cintE BOAAD Cif MW11..\Ti.4%u PISS(AIaED BY fttDEPARTh NT OF MIA'I CwztNMrwrrM:ANCE 1C 41.1-"4.1
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 eser for homestead fraud.homestead fraud causes higher tax bills for all;therefore.
HEA 1341-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
k-7II , F, \ benefit and to provide additional identifying information necessary to allow county owemment to better monitor homestead
�, filing,.This information will be kepi confidential and can only to accessed by�authorized county'ofciais.The Departnmt of
Local Government Finance will use this information to create toss's that will help couny officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
APR 1 2 LULU Taxpayer Name Property Address
��/a Mason, John/Doris J
' -0 let 72i F.State
GIBSON COUNTY AUDITOR Princeton IN 47670
2788
John/Doris J Mason
721 E State State Parcel Number Lesal Description
Princeton IN 47670-1911
Itlttlltttltllttltt rill 11111 Iltt tllttltl ttrllrr rill 26-12-07-204-001.225-028 019-01225-00 NS LOT 3 PT R3
PART 2:TAXPAYER INFORMATION
Owner 1 A _ F'irst e Middle Last
_nddrcv(uurnbei arid stns:,city:sat:;and-ZIP co:1.e).__ -- _ __ -------:-2 Same as property address.__
7a/ E. — . ✓ ) J 9,473
Spouse First Middle Last
Nat (.1 �e2-
Mailing Address(Number and street,city,state,and(ZIP code)
� l n` Same as property addrss
7 e / k,, L - s 7`�?/�-e Lax 97z 7e)
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 properly. 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 Signature Date
rt.�•n
�'°g CLAIM FOR HOMESTEAD PROPERTY TAX �
�:��'� CREDITISTANDARD DEDUCTION
�.,; � Sute Form Sa73 (R2/5-92)
�sL
INSTRUCTIONS: See reverse side for Iiling instructions.
FORM
HC10
� . 1 _ /��1 . . ,:� �=;:e,a
� !e) T I�� certify ihat on the tst day of March,
_`:� e) occupied as principal place of residence th Ilowing described reat property for which a Homesiead Property T����Edi�is�er��
l� ❑ I (We) owned , ❑ Are buying under coniract . . �
❑ Have a beneficial interest in the entity ihat is tiable for the property taxes on ihe property and that owns ihe property or is buying�undgr�a o
-. �
YEAR
�
� � � CONTRACTRECORDED �
If buyifg on contracL Fee Simple owner's name � � � � . . . - . .
Recorders oHice where comract is recorded Rewrd number Pa9e
PROPERTY DESCRIPTION �
County TownShip T�ing dislric� (city. towq townshipJ � _
Parcel num6er Legal description
= i��c�3-0c.1.:. �' � •
If any portion ot the residential suucmre or the land not ezceetlinq one (11 acre that immetliatety surmunds that structure is used to produce income, tlescnbe the use and portion
of the property utilized lo produce inmme. �
PROPERTV OWNED BY CLAIMANi IN OTHER COUNTIES�
County Township County
� veby cenify the above statements are true, correci and comp�ete. Signamre of daima22 _
✓ . lOZ��C/ /
Address (numbei antl slreeG ciry, sfate, DP code)
�/ %7/f ,
ASSESSOR USE ONLY
Land not exceeding 1(one) acre immediately
surrounding resideniial improvemenis.
Oiherland �
Total land (line 7 plus line 2�
Dwelling
Residentiai improvements
Garage
Other improvemenis
Total improvements (line 4 fhrough line �
Total value (line 3 pLs line 7)
I hereby certify the above is Irue. correct, and
complete.
��fvino action � Siqnawre of Audimr
TFiUETAX ' ASSESSED I HOMESTEAD
VALUE VALUE VALUE
i�)
I2)
(3)
(4)
(5)
(6)
(�)
18)
ofASSessor
NON-HES�DENTIAL
VALUE
Date signed
I