Homestead_Monroe •
SIAR FOR4.!KIR I WO TREARItLR FORM ASIA
AIIROVEO by SIAM 96ARDOF■RGSST'.ev,t PRE R1BW BY ME DEPARTMECOFtfAAE oovptNSW'T FRANCE Mf-I.1-_rl
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead yandani deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than eter for homestead fraud-Homestead fraud causes higher tat bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reecho the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing.This information will he kept confidential and can only he accessed by authorized county officials.The Depannsent of
Local Government Finance mill ua this information to create tech that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Monroe, Eddie V
IL
FED
1904 L lake Rd
Princeton IN 47670
1223
Eddie V Monroe APR 7 2011
1904 E Lake Rd State Parcel Number Legal Description
PRINCETON IN 47670 77 ��� 26-12-08-203-002.469-028 019-02469-00 DIKE SUB DIV 1 1OPT
_ --- — -- - __-- —GIBBON COUNTY AUdltgti
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 1 First ' / Middle Last
C�r.Ja_rd V O to o h r n
tg Address(number and strut,city,state,and ZIP code) 2'Same as property address
tRD4 Et. L&IACe Red ' >I�ri wee- vv L All 47407n
Spouse First Middle• Last
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 specify in Part 4 below)
scut
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 elieible 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
•
CL..41M FOR HORAESTEAD PROPERTY TAX b'
CREDRISTANDARD DEDUCT�ON G��
Sf� Fortn 5473 tR7 � s-ae) ,� i
Prasabad by Me Depertrneni of Laral Gorermas Fe�awe �
wsraucnavs: s� r�a� sda ro; r��y m��.
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FORM
HC10
��rt�7�
i(we) �,u11 J.4 v \ u 1 Cy ��!'t cerorr mac o� a�e � se aay a t�ard�, zo_
I(We) oocupied as an prmdpal plaoe of residence the fo9owirg descnbed real popEMy fw whid� a Homesfead Property T�c Cfedt is haeby dmmed:
I(We) owned ❑ he buy'vg unda oontrad
, Have a benefidal intere� in tl�e enfiry that is liade 6w Ihe poperty �ces m ihe property afd tliat owns the property or is Grying under a contraci
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tt buy"og on m�tac4:ee Sirtqle o.ne/s rema
(�rtler9 ol6oe �'hae wNa�1 is recadaC Rxad number Pege
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Pa�celrnurmer
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Tuvrsfrip
Legal Eesc�iption
Is tl�a
h1wn.
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I ' I �Rdal poparty LJ Mabik Fbne (lC. 61.1-� �
M arry partion d ihe residartial sNwtae a Ihe Imd nal �md�9 ona (7) eue tlat inmadalely airtaaWS fha� is uaetl b pmd�m'rnmma. desafie tha �e eM portion
d Ne poperry Wif�d m pm�ue e�mne.
a l�- �a -o� - ab 3-�,o a��t 1� 4- o a_�
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, _ . ,, . . " : , ' .: :-� PrtorQmr owHm er.cu�manr a bn�et coux�s•; _,: ,, . f.. .,.: : r n ,.. �,.'... �.b : A:
Caunty Tawnship Counly Tawnship
I he�eby certify the above sta6ements are true, carecl and conplete. �v�+re a damaa
(nurbn erd atreeC oA: smm. ZtP code) •
� .+. '.?'ASSESSORU�ONLY�'� •" g �F�til� �` TRUE�.TAX . /LSSESSmVALUE �Iff.S7EAD�,�. � ��4NON�'�����
,�: +i �,. VALUE; =AT100XOFTTV� F1 ��VALUE sr.`�;r sen.ar�'Y+'^�:VALUE�:-.�5"�". i7�'�j7?�
..Land rat emeadirg 1 (one) aae irtn�e6afiy � � "� ya�y.�fn ,� � `,�,t, ,"'��}>� � �3i ������_a
simamd'vg residential improvert�en�. i) � 3 sv > F�;:'�� L�'P n�`r�S'�•z'?5;.�e:'si
Olher lard iZ) ���in� �`.i:i'r ; -5.
T� land (I'ore 1 pArsln7e � (3)
�n�.yr rM .. 'p h .__
`�. �i r n 1�� ' � �'�,�`�+.
Resdential cnprwements or Mm�ally ��� �4� `� ah; ���.�s;:�?..F'..a`_r',s �w:3;�i.�!ti���
.�SPSSC� �E I�Al� ii0ffl@ ) i R +Y . F' W y Y "�'
��e �5) ' ����'t�.� a�t�%{•�v�.-�,ci+�` ��'��t`���"�.
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Otlier unpfOVerf�.n15 (g)" .::' , :....'.._,,'4',f,':., �,.;la :
Tdal vrryrovefnerrts ((are 4 lfvou� 6ne 6) (7)
Tatel value (I'sre 3 pka Gne n (g)
I I�ere�y certity the above is We� cortect and Sigreme otAsmma Dam aig�ed
complete.
Vniqing edim - si�pmme ora,6mr oam signea
'j : . . . . . ,-,STANDARDDSSUCTIONALLOWANCE .:,�� a, `�wr , -..1'�-.,'�'"5=""�[7±4
20 _ Pay 2b _
Lesser W 12 Homest�d
WJuation w 535.000 S
Sig�ae af A�dtar � �