Homestead_McRoberts MATE FORM 535.'RI/>API tRr.Uttu FORM f-IA
APPROCED Bl SI&TE BOARD OF ACM.%rl`nn PRFwtBFD BY THE DEPARTMENT OF Lt*At GM?LVMrNT FINANCE r.-IA-na1
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 ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-3009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept confden tial and can only be accessed by authorized county officials.The D epannenr 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
McRoberts, Jody L
213 Third AVE
Princeton IN 47670
394
Jody L McRoberts
213 3rd Ave State Parcel Number Legal Description
PRINCETON IN 47670-1011
Itl nllu tltllnlu F111 1111 26-11-12-103-001.754-028 019-01754-00 TOWER HGTS 109 PT/110
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
d ( l n n M c-Ro b-Q-2, S
0,g Address(number and street.city,state,and ZIP code) 111 Same as property address
a13S 1 1,,ctrc.I -AEG 47670
Spouse r I First Middle Last
Mailing Address(Number and street,city,slate,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last S digits) Other(please specify in Pan 4 below)
Sae
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
R, CLAIM FOR HOMESTEAD PROPERTY TAX
" CREDIT/STANDARD DEDUCTION
SIa1e Fortn 5473 ((� / 4.p;{)
Presaibed by ihe Department ol Local Govemment Finance
INSTRUCTIONS: See reverse side Ior filing insvuctions.
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JUN �
� (We) - �_.'^^`c�m ;'F'�v7I'� ���.�r: r�+,
certify��thatan fhe•�1'st day�oGMarif5,920 I
v..�,.,�,.i � .,�.,�,u...,—
I(We) occupied as ou 'ncipat place o( residence th foi wing descn ed real property for which a Homestead Property Tac Credit is hereby daimed:
�(We) owned ❑ Are buying under cont2ct
� Have a benefidal interest in ihe en6ry that is liable for the property taxes on the property and Nal owns lhe property or is buying under a conVact.
If buy'u�g om m�traq, Fee Simple ownefs name
Remrders ofice where contraC is remrdeA
Record number � Page
County Tamship T�g dislrict (cify, town. Iownshi0)
qPa�rcel Qnumber Legai description Is ihe pmperty in question:
J `^ �� eal Droperty ❑ Mobile Homo (/.C. 67.1-�
H any portion of Ne resiEenllal sW cture or Me Wnd not exceeding me (1) aue ihat immeCiatety wrtounds Ihal sW ure is used W produce income, descri6e Ihe use and portbn
of the WoGenY util'vxE tn praduce inmme.
County
I hereby cerG(y ihe above statements are W e, wrred and oomplete.
Addrass (numbei aM^Veet, cdy; sfate, ZIP cade)
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County
of
Tavnship
� �'�'�'��� • �- <�r�'���"3c�st;�`��-�STANDARD:OEDUCTION'ALI.OWANCE"��,���,�:���*;.�-�'�:3'��<`�.+'��';�i�.�-�
20 _ Pay 20 _
Lesser of 1/2 Homestead 5
vauauon w E35.000
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