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APPROVED BY TE YMFDrw MY4ti•,TS,904 PRr9ITIBm B\'PIE DEPARn EMrOFLQESL fAwi0.`iMQ,'T FINANCE IIC 6-1.1-2:4.1
Gibson Courtly Author
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 become
•
more beneficial,there is more incentive than nor for homestead fraud Homestead fraud causes higher tat bills for all:therefore.
• HEA 1344-2000 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe the
benefit and to provide additional identifying Information necessary to allow county government to better monitor homestead
filing.This information will he kepi confidential and ran only be accessed by authorized county officials.The Ikpanment of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Mattox, Nathaniel/Cynthia Mae
428 13 Glendale
Princeton IN 17670
716
Nathaniel/Cynthia Mae Mattox . -
428 E Glendale - - State Parcel Number Legal Description
Princeton IN 47670-1645 .
1 1 11 i i 1 i i 1 III iii 26-12-06-403-001.714-028 PT NE 7-2-10.02 AC PT SE
t o ul O il nn uuu n nu li n t to t ll t ul C " 6-2-10-55 AC WARNOCK38 PT er,
iiiii
Abed tht c36-/a\66- ye8 -09 y. 3 68-oak
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
A'}4-T/4Af17ek NoNG M- x
• tg Address(number and street,city,state,and ZIP code) Same as properly address
2 c > G-L.ANDAL e S /` I
Spouse First - Middle Last
CYNTHIA MsA� T -r ox
Mailing Address(Number and street-city,state,and ZIP cock) - ® Same as property address .
- —�— —�--'Each undersigned certifies,under penalty of perjury.that the above and foregoing information ii 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
. illIl
w;M Mc �o is�9
PrescriGeE By Sta;e BoarO oi TaK Commi55ioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19_`1_�
ia Be FileO in Uuplica�e
. �
, SEE BACK FOR FILING INSTRUCTIONS QrC,— OO
`� (We) ' _ certify that on the 1st day of
���arch, 19��_, I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
0
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial intjjrest in the taxpayer
Property Description i
Taxing District (City, Town, Township): G
Parcel Number ��
���� Township
or legal description shown on tax statement:
Q�t 91�%l 7-�-/0 ,O�cz�o
Q�. .g%� 6-a-io .SSa.w-d
�v�.�� �/2.
If buying on contract: Owners name �'�` "'"°1e °"'"e"
Contract recorded in Recorders Office - Record
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 oi 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.
n
County Township
Individual either owns or is buying under a contract that provides he is to pay the properiy taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
True Cash
Value
land nnt exr.eedino 1 fonel acre immediatelv
0
Assessed Homestead
Valuation Valuation