Homestead_Owens STATE FORM!3:1*OCI•4.0 THE SUIIR rORYY,1
APPROVED BY MATE MAADOFArRAPTS.a. PRESCRIBED BY RIFDEPARTOefror LOCAL oovetIMrTR FINANCE ICr-I.I-U-IIS
Gibson County Auditor o.
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 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
flint .This information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tech that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Owens, David R/Frances E
701 N Ilan
Princeton IN 47670
776
David R Owens
701 N Hart State Parcel Number Legal Description
PRINCETON IN 47670-1451
IllttlltrtlElltrltttlll IltlttlElElrtttllll 11111111
26-12-07-102-001300-028 019-01700-00 OLD PLAN 147PT
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 I First Middle Last
DRVID ARy 0cJEN5
"kg Address(number mid meet,city,state,and ZIP code) 1 �7 1 it Same as property address
/ c/ /1/ceiL: Watt S -ec l Prin<• -/on 1/V V7 7o
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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 properly.Each undersigned also understands that,by claiming additional homestead deductions
unlawfitlly,he or she may for back taxes and substantial financial penalties.
Owner 1 • tore 7
1110
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� CLAIM FOR HOMESTEAD PROPERTY TAX
= CREDIT/STANDARD DEDUCTION
State Fwm 5473 (R4 / &00)
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INSTRUCTIONS: See reverse side for filing ins6vc6ons.
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1(We) 6/\Y wl/ �-tX YL `� �17 lit.(/ f�-C.�U t i CY"" — o�tha6emil}�•1US��y
I(We) ocwpied as our principal place of residence the follmx"vig desuibed real property for which a Homestead�r pe�7^ac��ietliti's'� Be��med
�vn I e) owned ❑ Are buying under contract
e a benefidal interest in the entity that is liable for the property taxes on the property and that owns the properly or is buying under a contrad.
It buyifg on conlracL Fee
Recordefs ofice where
mefs name
recorded
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Toxnship
Legal desaipGOn
^ . � Record number � Page
l/! 7—V! / w w �
If any portion of ihe residentiai sWClure or the tand frot exceeding one (1) aae that immediatey surrounds Mat struUure is used to protluce income. Eescribe the use and portion
ot tne property u�lized to yoEUce iMame. - . .. , . .
20_Pay20_
Lesser of 12 Homestead
Valyation or E6,000
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