Homestead_Pickersgill STATE FORM!4Y,RP/>ael 1R:AwLB!ORM TS-1A
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Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS-
101 N. Main Street Individuals and harried couples are limited to one homestead standard deduction.A s the receipt of this deduction becomes
Princeton, IN 47670 more beneficial.there is more irccnuw than ever for homestead fraud.homestead fraud causes higher vas bills for ell:therefore.
IIEA 1344.3104 requires taxpayers who receive the homestead standar(deduction to verify that they are eligible to receive the
bcnclit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.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 crate tools that will help comm.officials eliminate homestead fraud.
PART 1:PROPERTY INFORMATION - '
Taxpayer Name Location Address
Pickersgill, George A/Amy L
407 W STATE ST
PRINCETON IN 47670
710
George A/Amy L Pickersgill 1111°111m II I VI II II II VIII mil II IH III II_III III DI_III 111111111111111
407 W State ST
Princeton IN 47670-1343
II'llll"'llll"ICI'III'III'III'II'II"II'flllttllIlltlrlllllIlIt State Parcel Number Legal Description
26-12-07-103-002.791-028 EVANS ENLG 16PT
i
FILED
APR 1 6 2012
This form MUST be returned to County Auditor's office;..
Please do NOT send this form back with your tax payment to the county t rer.
G a ON COUNTY AUD TOR
. PART 2:TAXPAYER INFORMATION' ' ' •
.tier I First , Middle L Last
-7 F og e (2._v � 4 5 4 L
Mailing Address(manlier and street.city.state,and ZIP code) J ;Same as propcny address
4o7 vv_ STh-re_ S4--,
Spouse First Middle 4 Last
y �f ciLEAsel (L __
Mailing Address(Number and street,city,state.and ZIP code) Same as property address
S\4414 NI
Each undersiened 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 b liable r back taxes and substantial financial penalties.
Owner I Signature Dare /6
A (� z
- '
i
�� CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
Y '. CREDIT/STANDARD DEDUCTION HCiO
SWte Form Sa73 (R2 / S92)
+ ;-,i
.,. _
INSTAUCTIONS: See reverse side lor liling instructions.
t(We) T W I ViJUC/ ' certiy that on th€Y3tHay oiMarch, 19_
I(We) occupied as our pr ipal place of reside c the tollo mg described real property for whic Ho estead Propetty Tax Credit is h�by dai :
❑ I(We) owned ❑ Are buying under coniract � �. %
���-��1y� ..,amF
, Have a beneficial interest in ihe entity thai is liable for the propeAy taxes on the property and ihat owns the pr rty_mis_bLyufg� under a�contrad.
- . _.. CONTRACTRECORDED;�, �-. .4. . ..-.-, ..�.;>., .. . � -. �:�:�:G=.-
If buying on Con(ratt. Fee Simple owner's name
RetorCer's oflice where Contraci is reCOrdetl Record number Page
Towns�ip
PROPERTY DESCRIPTION
Tasing distria (
Par�l�urybg_ I Legal descnption C] � r
U %" � a � 4 �-c� � t �
If any ponion of ihe residential strucNre or t�e land not exceeding one (7 � aae that immediatey
ot the properry uulizetl ro protluce income.
-_ .--.`� . . ..
struciure is used to produce income, descnDe the use and portion
. � ASSESSOR USE ONLY � � TRUE TAX ASSESSED - HOMESTEAD NON-RESIDENT1Al:_ �
.. � VALUE � VALUE VALUE - VALUE ��-�-°
Land nm exceeding 1(one) acre immediately , "-r -
surrounding residential improvements. ��) ����
Oiherland (2) � ' �
Total land (line 7 plus line 2� (3�
Dwelling (4) � . . -.
Residential improvements - .
Garage (5) _ '
Other improvements (6) �
Total improvements (line 4 through line � (7)
Totat value (line 3 p�s line 7� (g)
I hereby certity the above is Irue, correcL and Sgnamre of Assessor Dace signed
complete.
Verifying action - SgnaWre of Audiror Date sgned
79_Pay19_
Lesser of 1/2 Homesiead
Valuation or 52.000
S
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