Homestead_Midkiff ST ME FOIIM n,.miR_/Wit TU./SLUR FORM 11A
APPROVED DV MATE BnAR0 Of MTTOTT,.m,M PRTSAT W BY nil OEPARrSCYC(i L(R.LL C veroti'r EV:hV'E M V1.1-rra.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 IndividuaLs and married couples are limited to one homestead siandani deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than excr for homestead fraud.Ilomestead fraud causes higher tax bills for all:therefore.
• HEA 1333-2009 requires taxpayers who receive the homestead standard deduction to verify that they am elicible to recent the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing.This intbrmamon will he kepi cnntidauial and ran only be arressed by authorized county ofticiIIIs.The pepanntcnt of
Local Govumnent Finance will use this information to create touts that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
--a. Midkiff, Diane
601 E Emerson
Princeton IN 47670
2821
Diane Midkiff - ,__ — -- - — — — — —601 E Emerson State Parcel Number Legal Description
Princeton IN 47670-1901
I t l t t'I t t t l t l l t t l t t t l l l 1 1 1 1 1 1 1 1 1 1 1 1 1 I l t l t t l l 26-12-07-204-003.626-028 019-03626-00 NS LOT 1 PT R2
PART 2: TAXPAYER INFORMATION
Owner I First Middle 1,� Last
sI N Ne- '-ice- lr! ide,-{
— -
•Address(number mil at city;state,and ZIP code) -- — - --- --�(l fnn e ns property address _ _ _ — _ __ ___
f.
(on! L, Eme .e.so Si; 2:,k3C.f „r .( ,IA 47676
/�
Spouse First Middle Last
NS Dv`r
Mailing Address(Number and street,city.state.and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please spaify in Part 4 below)
5=
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.
Ownc Signature Date
S
_. ....
, fJ u�t
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19�"D_ �
SEE BACK FOR FILING INSTRUCTIONS
', '""�� '''" • certify that on the 1�of
P�, 79 I, (We) occupied a ur principal place of residence the followirig described real property for
w. a Homestead Property Tax Credit is hereby being claimed:
�, (we)�owned O ' ,3G'.2 (a�/ '
❑ are buying under contract - �// O
❑ have a beneficial interes�t fiPA the taxpayer ' � •'
Property Description in_ /"�! 1� County `� Township
Taxing District (City, Town, Township): '�"P*''
Parcel Number or legal description shown on tax statement:
_ N.s. iRa,�-�
If buying Ofl contract: Owners name ��ce s�mo�e ownerl
Contract recorded in Recorders Office - Record No. 5 Page- 5�0�
If any portion of the residential structure or the land, not exceeding one (1) acre ihat immediately surrounds lhat
structure is used to produce income, describe the use and portion of the property utilized to produce income
0
Any other counties in which individual owns or is buying real property:
I hereby certify the above statement is true, correct and complete
County Township
� . , ..� . v . , ava� naoresa . . . ,. - : Giiy.
Individual either owns or is buying under a contract that provides he is to pay the �
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
and not exceeding 1(one) acre immediately
urrounding residential improvements
Ither Land
btal Land
Iesidential Improvements Dwelling
Garage
Total
Ilher Improvements
otal �ovements - Line (6) plus p) equals (8)
herc. ertity ihe above is true. correct. and complete.
ignaWre ol Assessor
Ipproved
�
(1)
(2)
(3)
(4) _
i,�aY � 01939
�e� �' Y3�.rs
True Cash Assessed a����Homestead
Value Valuation Valuation
( 5 ) %�%/%%%%%%%%///
�s�
l�l _
($)
- ACTION BY AUDITOR -
Oalu
P9 � `
1.
Date: _ �_'�_� 9 ___
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