Homestead_Perry (16) MAit FORM!),P• /Wel TREASURER FORM n-1A
A/MOVED BY x T Im BOiROOF MYT.I'R.2vm PIF3ALBm BY PIE BrpAanons{L(R'AL GOVERNMENT FNANCE R'6-1.1-_4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
si PRINCETON IN 47670 IndividuaLs and married couple are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ewer for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1343-2009 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to recei'e the •
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kepi conhdaltial and cm only lx:accessed by authorized county officials.The Depanntent 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
Perry, Jack L/Janet L
513 S Prince
Princeton IN 47670
2946
Jack L/Janet L Perry
513 S Prince State Parcel Number Legal Description
Princeton IN 47670-2427
14144 11t tt 1tllr FlFFtlllt mmmlii 1t111 1FF1t11tFr 1r FF11Fr 11dFFril 26-12-07-304-001.919-028 019-01919-00 WILLIAMS 2 PT/7 PT
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
• Eft LC w :L1 R>°g
1:.1ailcg Addrma(ntmbercrds•.r -cita::re.d.ZlP:odc)—_- _-_ __-__ - - - - -4mespretpertygddress-- ---�- - - _ _
513 S Pr r` ncz°
Spouse First Middle Last
Jane j- 6 it e iee r
Mailing Address(Number and street,city,state,and ZIP code) ® Same as property address
S/ 3 5 . P/',lt re sf./ ce*en V7470
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 standar, t-tuctio on this property.Each undersigned also understands that,by claiming additional homestead deductions
unlawfidly,he or she may .- liable fo tack taxes and substantial financial penalties.
Owne .ignature Date
`""" CLAIM FOR HOMESTEAD PROPERTY TAX
,a ^��
CREDIT/STANDARD DEDUCTION
.
� State Form 5473 (R2 / 592)
'�f�� "
16
INSTRUCTIONS: See reverse side /or /iling instr�ctions.
FORM
HC10
YEAR
CER IFIC N STATEMENT
I(We) �ce-rt7ifpy ihat on the 1 st day of March, 19_
I(We) occupied our principal place of residence following describe real property t � mesi�ar•o ax Credit is hereby claimed: �
❑ I(VJe) owne ❑ Are buying under con ract � � � A
❑ Have a beneficial interest in the entity that is liable for the property taues on the property and that owns the property or is buying under a contract.
CONTRACTRECORDED
It buying on contract, Fee Simple owners name •' / �
�
�' -v/Ni
Recordefs oKCe where conVad is recorded � � �=- V�-� � i • rd number Paqe
PROPERTY DESCRIPTION �
Counry Township Taxing district (ciry, town, (ownship)
p3rc I ry�b-r Q � Legal descnplio
rn c�
If any portion ot Ue residential stnicture or the land rwt exceeding one (1) acre thal immediatety surrounds that s ure is usetl m p otluce incwne, descnbe the use and portion of
Ne properry utilizetl to pratluce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Counry Township
Signatu of clai ant
ereby certify the above statements are true, correct and complete.
Atlaress (number arM sfreet, ary, sla7e, ZIP code)
-r 7D
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VAIUE VALUE VALUE
Land not ezceeding 1(one) acreimmediately ���
surtounding residential improvements.
Otherland (2) -
Total land (line 1 plus line 2) (3) `
Dwelling (4)
Residential improvements
Garage (5)
Other improvements (6)
Total improvements (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8) '
I hereby certify [he above is �rue, wrtect, and Signature of Assesor Date signed
complete.
Veritying action - Signature of Autlitor Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead g .
Valuation or 52,000
Sigrature of Auditor Date ' ed — �`�