Homestead_Pugh (4) SLUE FORM ne4 IEI 5+1.1 IDEASURER ROLLM 31A
APYROCEO By Sr&IE BORDOF■ETR:cec2I . PIESCRIDED BY TIE DEPARnHEVTer LOCAL GOVELNM11,7 FINANCE IC 6-I.1-r-4I
Gibson County Auditor HOMESTEAD PROPERTY OWNERS IMPORTANT NOTICE TO H
101 N Main ,
PRINCETON IN 47670 Individuals and married couples are limited to nnc homestead standard deduction.As the receipt of this deduction becomes
A more beneficial,there is more incentive than eser for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 13,44-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to creche the
benefit and to provide additional identifying infornatton necesry 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 Depanment 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
Pugh, Damon R/Angela J
205 N 7th
Princeton IN 47670
418
•
Damon R/Angela J Pugh
205 N 7th State Parcel Number Legal Description
Princeton IN 47670-1103
1 1111 I 111 r l l l l t t l t t t l l l I l t t t l l l l I l l l l t t t t l l l t r l l t t l 26-11-12-203-000.678-028 019-00678-00 BMA 41/42/43/44 PT
This form MUST be returned to Cou Y
t 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
•ig Address(number and street.city,state,and ZIP code) 121Same as propeny address
Jn 6 ks —t n nee)" I ✓IL-cio v\ c--{-7Cv-R D
Spo%�e I First Middle I Last
t rvl 0 PSI -4 J-e,cC., �LA 9 4
Mailing.4ddresi(Number and sweet,city,state,and ZIP c ) I-1 S±n a as property address
5 /U �f / /�t aI 47C�LuvJ`k7
PART 3:CERTIFICATION 9
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 I Signature 'Date
7 • .
���� CLAIM FOR HOMESTEAD PROPERTY TAX
a;� CREDIT/STANDARD DEDUCTION
,�, � Siate Form Sa73 (R2 / S92)
yu
INSTRUCTIONS: See reverse side lor7iling instructions.
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I(We) � - � � ce ry that on the tst day ot�March,� 9_
I(We) occupied as our principal place of resi nce ihe following de ibed real property for which a Home�d Prop�Teu Credit is her by aimed:
J '��-
❑ I(We) owned ❑ Are buying under contract GIBSOi�` :�vU`�T`.' 'UC�TOR
. Have a beneficial interest in the entity that is liable tor ihe property taxes on the property and thai owns the property or is buyin9 under a contraci.
�.`-i . .;..' �,.. , ,. - ;����-. .-_-0ONTRACTRECORDED;:»� .�..,.'i,:r [ .--��' },"�- -
s �i� ,.-�
. - .._ .. , .� � -.. .. .. . _ .. . . - ...., . _. . . . .,
II buying on coniratl. Fee Simple owner's name
Recorder's oHice where contraa is recorded Record number Page
Counry Township
Legal
ponion of ihe residential structure or ihe IarW not exwetling one (7) acre thai
properry ulilized to pro0uce inmme.
�a
' ��T
is used ro produce income. describe the use antl portion
_ � ' � �� � ASSESSOR USE ONLY -`.� � TRUE TAX ASSESSED HOMESTEAD - NON-RESIDENTIAL. �
�� . . . � . . VAWE' � VALUE VALUE . VALUE ���
Land not exceeding 1 (one) acre immediately , � . � � � - � ,
surrounding residential improvements. (�) `` ,
Otherland (p) �� `� �
�..eYn�odr�r�¢. r=.�
Total land (line 7 plus line Z� (3)
Dwelling (a) �� �-
Residential improvements _ � . �l -
Garage (5) � , .
Other improvements (6) �
Total improvements (line 4 fhrou9h line � (7)
Total value (line 3 p�s line 7� (g)
I hereby CeRify Ihe abOVe i5 irue. Correct, and Signature ol Assessor Date signed
complete.
Verifyirg action - Signature ol Auditor Date signetl