Homestead_Moore (9) RIVE FORM!!!W ilef•■•l TREASURER FORM VS-IA
AFF ROVED BY yrot WARD nrM tivrc.8.n PRn_YWBPDnY TUT DEPARTMENT OF LOCAL GOVERNSIr NT FINANCE IC 4,1-2:4.1
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 1344-2009 require'taxpayers who receive the homestead standard deduction to verify that they are eligible to receive a the
benefit and to provide additional identifying information necessary to allow county govemment to better monitor homestead
filings. 11 s information will he kept toad-mint and can only be accessed by authorized county officials.The Department 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
Moore, Judy E
919 S I Rall
Princeton IN 47670
3662
Judy E Moore
919 S Hall State Parcel Number Legal Description
PRINCETON IN 47670-2333
�t�u ut�t�u 26-12-18-101-001.837-028 019-01837-00 PT NW 18-2-10.27 AC
n
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
JOct / 1lq0D r
•tg Address(number and street,ci state,and ZIP code) —-- — - "ffSbme h property nddiess' -- -- -
/ SOO # lRLL Sr. Roo 16feei-6f r/
Spouse First Middle Last
Mailing Address(Number and street city,state,and ZIP code) []Same as propeny address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Sus
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
•
waM xc �o iem
HescriDeO By State BaarG al Taz Commissioners
CLAIM FOR HOMESTEAU PROPERTY TAX CAEDIT FOR YEAR 19��
To & FiIW in Duplicate
. ✓
SEE BACK FOR FILING INSTRUCTIONS D/� � D/ �?�'Q,D
( ( J
�(We) •� �� certify that on the 1st day of
.�arch, 19 occ ed as our p ncipal p ce of residence the following described real property for
which a Ho stead Prop �Ut Tax Credit is hereby being claimed:
_�
I, (We) ,KJ owned
�❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in �
Taxing District (City, Town, Township):
Parcel Number
Township
or legal description shown on tax s[atement:
�� • �Yl`l,<J % i 8 -� -/O . � ��.�
If buying on contract: Owners name ��� sim0�e o.�e��
Contract recorded in Recorders Office - Record No. Paae
If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that
structure ig used to produce income,'describe the use and portion of 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. .
�„--, ��UUi-e.� 9/ `� .('. .�la�.�. �
County
Township
ana Zip CoCe
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneticial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY
Land not exceeding 1(one) acre immediately
surrounding residential improvements
Other Land � � __, � �
Total Land �
True Cash
Value
(�) � a ? `�
(2) —o—
(3) /�SLv
Assessed Homestead
Valuation Valuation
.
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Date: � - �9- 7 �