Homestead_Modafari RIME FORM!!•ro1R:I,,n1 OCEANIOI POEM iS1A
.,rrrrwED BY MATE BARD elf ACCra NIC.:UV PArr mas BY Mr DEr 1so TOF leCALnovEtNNEATPTA\CE IC 41.1-`:-II
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS '
101 N Main
C T IN 0 Individuals and married couple.are limited to one homestead standani deduction.As the receipt of this deduction becomes
II) more beneficial,there is mote incentive than ewer for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
OP) HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recebe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be accessed by authnrired county officials.The Department of
APR2 3 2010 Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
0a ee Taxpayer Name Prnpertc Address
Modafari, Brian K/ Kathleen M
GIBSON COUNTY AUDITOR
414 S Gibson
Princeton IN 47670
3102
Brian K/Kathleen M Modafari
414 S Gibson State Parcel Number Leal Description
Princeton IN 47670-2402
•
111rt11rr tIrllrr�tlrlllt Ill rlt 1tlttl1lrtt ttlr1t rtl1t 1rr 1rtl1t1 26-12-07-403-001.130-028 019-01130-OO CLARKSVILLE 2 PT/27 PT
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
r2I- an -K rnoi)rt-FA 12T
- -latg Address(numb cd street.city.s:a:g,=I d ZIP Code). - - - - --_- - — — _2:Same es property address— - - --- - - -
-
Spouse First Middle Last
erl
44 a-111It _ArN fhCabA-FA-Pe_r
Mailing Address(Number and street.city,state,and ZIP code) ICa•Same as propeny address
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 ' e tr y be liable for back taxes and substantial financial penalties.
Dale
a� -'��' � CtAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
;��E CREDIT/STANDARD DEDUCTION riC�o
.�..�,,��� State Porm Sa73 (R2 / 5-92)
an
INSTRUCTIONS: See reve�se side tor liling instiuctions.
1 �`Ne) _d � /!.(I1 /ll ) i /�(g� C�SL.(R/� � / / certify th�6on:itlel�t.9a�ei�A�%74,' 19_
�) occupied as our principal place of residence the following described real pro rty for which a Homestead Prope�ty��Crecyj i�p�py claimed:
� I(We) owned ❑ Arebuying under contract (�� O ��}
❑ Have a beneficial interest in the eniity that is liable for the property taxes on the property and that owns the pr� rty or is bu 'ng er a contract
.. . - - . Ti� �_.. . � �,_.�� .
- CONTRACT RECORDED � . �
If buyirg on contracC Fee Simple owner's name , -
Recortler's oMice where con:rect is recortletl ' Recortl number Page
Townsttip
Parcel number
PROPEflTY
Cl/ /' V// 4JC J- (�) I �Yx! ? w,�JN JCJ' 1
If any portion ot the residen6al structure or the land not ezceetling one (�) aae that
ot the property utiiized to produce income.
fown.
is used to produce income, describe the use antl porUOn
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
— VALUE VALUE VALUE VALUE
Land noi exceeding 1(one) acre immediately
surroundingresidentialimprovements. (�)
Oiherland (p)
Total land (line 7 plus line 2) (3) I
Dwelling (4)
Residential improvements
Garage (g)
Oiher improvements (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p6s line � (g)
I hereby tertify Ihe above is lrue, Correct, and SignaWre m Assessor Dare signed
complete.
"--"virg action - Signature ot Auditor Dare signed
19_Pay19_
Lesser of tl2 Homestead
Valuation or 52,000
oi
S
ALLOWANCE
ign�p' -nj �/
S�