Homestead_Peterson slat l Gni!3!M,IL'/W+1 TRYASULE11 FOLY iStA
Apra.En BY SislL BMMOf AM 4 Lsts!mg PLr.V11Bm BYnlrnrPA/U:ER('LOALrrot^etw.O.T MANCEIr 6-I.1-r4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
*PRINCETON IN 47670 Individuals and married couples arc limited to our 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.
HE.\ 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to pmcide additional identifying infonnaron necessary to allow county government to better monitor homestead
tiling...This information will he kept conlideminl and ran only Iv accessed by authorized county officials_The Department of
local Government Finance will use this information to create Iculs that will help county officials eliminate homestead fraud.
PART 1:PROPERTY INFORMATION
Taxpayer Name Property Address
Peterson, Brenda K
303 W Walnut
Princeton IN 47670
2568
Brenda K Peterson
303 W Walnut State Parcel Number Legal Description
PRINCETON IN 47670-1249
26-12-07-104-001.264-028 019-01264-OO FOREST PARK 3 PT
•
PART 2:TAXPAYER INFORMATION
Owner y� First Middle Last
Ogrmoc\ K1 I eecsbA PCBrersO/\-
Mailing Add=(rcmSc sd s:rx::city,e:c:C,tad ZIP Code}_ - __ . .rl S_me_=propertyeddress --- - -_ _ - -
303 tAJI LUaInu* S4
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 Pan 4 below)
Sale
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 ignature Date
„.f�•�.
� ' °„ CLAIM FOR HOMESTEAD PROPERTY'TAX
�•��'' CREDIT/STANDARD DEDUCTION
Sta;e Form 5473 (R2 / 5-92)
;� S•
�e�a
INSTRUCTIONS: See reverse side 7or liling instructions.
. � . � . - CERTIFICATI
�
s ;��' ;,i _
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�h� I Y��N..C:4L(�Cla'��d%W/ILCQ �.. 1 X^”" c�iha�tonihelstdayofMarch.l9!�
:upied as our principal place ot residence ihe following described real�propert for which a Homesiead Property Tax Credit is hereby Gaimed:
� owned ❑� Are buying under contraci ��
a beneficial interest in ihe eniiry thai is liable for the property taxes on the property and ihat owns the property or is buying under a contract.
CONTRACTRECORDED
If buying on contract, Fee Simple owner's name.
Recortler's oHice where contract is recortletl
. ,
� � PROPERTY DESCRIPTION
County Township Taxirg district cit . towq lownship)
, _ �
Fecortl number � Page
v ' `i
Par number Legal description
�iq - d � l� -oo
If any portion of Ne resitlential structure or the land not ezceeding one (1) aae that immediatety surrounds thai struct e is used to produce inrome, descrihe Ne use and portion
o( ihe property utilized ro produce income.
a
ASSESSOR USE ONLY
Land not exceeding t(one) acre immediately
surrounding residentiai improvements.
Otherland
Total land (line 1 plus line 2�
Dwelling
Residential improvements
Garage
Other improvements
Total improvements (line 4 through line �
Total value (line 3 p�s line 7�
I hereby certify the above is tme, correct, and
complete. � /� /
79_Pay79_
Lesser of 1/2 Homestead
Valuation or 52,000
ot Audiror
(�)
(2)
(3)
(4)
(5)
(6)
(�)
(8)
TRUETAX I ASSESSED
VAWE VALUE�-
A55e55or
STANDARD DEDUCTION
S
HOMESTEAD ( � NON-RESIDENTIAL
VALUE VALUE
Date signed
Date