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Homestead_Oursler • xtAR FORM:0N.IR Ifall WASULTA FOtM Y1A APPROVED BY STAR AMID 01'•ryTr.'IS.tan PAEAAIBmny 111E DEPMTM173T 4L( AL r0VILNMFAT FINANCE 1C I.l.b-tI Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and married couples are limited to one homestead aandard 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 fix all:therefore. HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to receive the benefit and to provide additional identifying infomlmwn necessary to allow county government to better monitor hontesead filing,This information will he kept confidential and on only be accessed by authorized county officials.The Department of Local Gmenment Finance will we this information to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address _ antler, Jerry W 810 N Second Princeton IN 47670 2415 Jerry W Oursler 810 N Second Street State Parcel Number Le2a1 Description Princeton IN 47670-1244 26-12-07-101-002.060-028 019-02060-00 CUSHMAN ADD 13 PT/14 PT Itlitliterlellieltrelll II 't I t I n I t I n I oI III nn I D II PART 2:TAXPAYER INFORMATION Owner I First Middle Last TCRRI am/NE ova RSLeR - e Address(number and stoat,city,state,and ZIP code). -- - _ - El Same as property address 8/D/✓ 2,N7-� 5fRe e f Spouse First Middle Last VENZTR 7.41y (9u>esUER Mailing Address(Number and street,city,stale,and ZIP code) © Same as property address 8/oi✓ 2/ :fReef 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 • FOflM MC 10 1979 PrewiEeC By State Boa�a oi Ta. Commissfaners CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 �� To Be FileG in Du0licaie �/ SEE BACK FOR FILING INSTRUCTIONS Q�C''� QaQ(oO' �O-. ��We) �"L`�''�'� � � � �� � certify that on the 1st day of March, 19? y I, (We) oc ied as o r principal place of residence the following described real properiy for which a Homestead Property Tax Credit is hereby being claimed: I, (We):�, owned ❑ are buying under contract - ❑ fiave a beneficial interest in the taxpayer Property Description in C' b s o^� County �'4 T�'�� Township Taxing District (City, ow Township): Parcel Number If buying on contract: Owners name u� simoie G�To.�/ or legal description shown on tax statement: S��f�a-r_t..�—.�. Conc�.e.. . . /� �i�, �/`/�. Contract recorded in Recorders Office - Record No If any portion of the residentiai structure or the land, not exceeding one (1) acre that immediately surrounds that structure is 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: ereby certify the above statement is true, correct and complete. f/, ��v0 sT- County Township „ o , Ci;y. S�a�e am 2io Wae ' Individual either owns or is buying under a contraci that provides he is to pay the properfy taxes on the residence, or has a beneficial interest in the taxpayer. - FOR ASSESSOR'S USE ONLY - Land not exceeding 1(one) acre immediately surrounding resideu� I improv�ent� Other Land p Total Land Residential Improvementsl�"i2 ���9 Dwelling ���J� Garage j�r Total !ij True Cash Value (>> /380 (2) � ' �s� /33°0 Other Improvements AUDITOR T� Improvements - Line (6) plus (7) equals (8) I �,.,�eby certify the above is true. correct. and complete. _ �� r A Si9na:ure ol Assesmr (a) ��Fo (5) �6� 8 � � (�) — (8) � - ACTION BY AUDITOR - Assessed Valuation �!o 0 Homestead Valuation S< G o (�—e2o-7% oa:e Oate: � �-Z- - 7 9