HomeMy WebLinkAboutHomestead_Priestly (5) TTAT£FORM!OPRER2I YNI TRFALntIA FOR;fl-IA
APPROVED REMADE B01RD OFMx14NT4:nn PRFSAmm BY TOTE DEPARTMENT OF LOU'1 CO ER: WI/NANCE IC 4-1.1."2-A
Gibson County Auditor
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
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more beneficial.there is more incentive than ner for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
Wir ILEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verity that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings. this information will he kept confdential and can only be accessed by authorized county facials.The Depanment of
Local Government Finance will use this information to crease tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Priestly, Portia
113 N Sth
Princeton IN 47670
427
- . Portia-Priestly _Y
113 N 8th State Parcel Number Legal Description
Princeton IN 47670-1109
LIttlltttLlltlLlJll • IltttlllLttLltttlJLlllttttlll 26-11-12-203-002.211-028 019-02211-00et A73
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.
I PART 2:TAXPAYER INFORMATION
Owner I A // First Middle ,(, Last
gig Address(number and street,city,state,and ZIP code) Same as property address
Spouse First Middle Last
Mailing Address(Number and street,city,stale.and ZIP"code) . ❑ Same as property address
Social Security Number(last 5 digits) I Drivel specify Diver's License/State ID Number (last 5 digits) Other(please ecify in Pan 4 below)
Sa
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.
Owne Signature Date
0
wun Hc �o �srn
HescriGM By State BoarE of Tax Commiuioners
CLAIM FOR HOMESTEAD PAOPEATY TAX CREOIT FOR YEAR 19 `��
To & Fi1M in Duplicare
�/
SEE BACK FOR FILING INSTRUCTIONS p�q _ o a a ��- o0
�''' (We) `�� certify that on the 1st day of
rch, 19� I, (We) o cupied as our principal place of residence the following described real property for
�ich a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in �-�-<<-a-o-^- County
Taxing District (City, �ew�; Tev�nskiip): Z
Parcel Number � or legal description shown on tax statement:
l3 />'1 R 7 3
Township
If buying Ofl contract: Owners name ��� sim0�e owne�l
Contract recorded in Recorders Office - Record No. Paoe
If any portion of the residential 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:
I hereby certify the above statement is true, correct and complete.
� JI J —% .. ,lt � _ � �-.1
County Township
ana
Individual either owns or is buying under a contract that provides he is to pay the property 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 residential improvements
Other Land 4� N , D
Total Land � 1 �J j�
Residential Improvements 1 Y
MAY 1 Dwelling
e
�' OUp�T;;;t Total
Other Improvements
To�mprovements - Line (6) plus (7) equal! (8)
I_ � certify the above is true. correct. and complete.
Signamre o1 Assessor
Approved
(�)
(2)
(3)
(4)
(s)
(6)
(�)
True Cash
Value
'� So
�So
I 3 So
�_/
$ o .�?'
�gj / ! � S O
- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
/So
/So
�
Da:e
Date:
/So