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Homestead_MeltonCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR CREDIT /STANDARD DEDUCTION -Tr 1 Stets Farm 5173 (De /4-M) Department 'T— Prescribed by cite Deparanent d Loral Government Finance I INSTRUCTIONS: See releroo &I do Rr IMV kmft ctww I (We) �• UA-4hN\ ( P 'T- ( U 11� f I f / LIM—K.*Wr 1 certify that on the 1 stt day of March, 20_ I (We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby daimed: ❑ I (We) owned ❑ Are buying under contract GIBSON COUNTY AUDITOR iHave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract NTRACTRECORDEDaz'` t_S F J_ • If buying on contract, Fee Simple ownefs name Recorder's office where contract is recorded Record number Page g't+l''� -�.er =a-. xVACUE _. _ . - _ ... s._' :r erX r, _. P.ROP,ERTY,DESCRIPTIONT�T"�44 :. r,,;,,>i= i'.�g� ."�.r.- �„_�y�';; -•: County Township County Township Taxing district (city, town, township) P _ WV L dress in not s t, city; oats ZIP code Is the property in question: ❑ Real property ❑ Mobile Homo (LC. 6-1.1 -7) If any portion of the residential structure or the land not exceeding bne of the property utilized to produce income. (1) acre that immo&tely surrounds that structure is used to produce inm e. describe the use and portion Land not exceeding 1 (one) acre immediately D -CY1 g't+l''� -�.er =a-. xVACUE County Tmnship County Township I hereby certify the above statements are true, correct and complete. I ature of c ant t dress in not s t, city; oats ZIP code AT1700 %,OFTTVVALUE?.�,r" g't+l''� -�.er =a-. xVACUE 'TRUE TAX" ASSESSED VALUE T,-3H MESTEAD #"'t NONYRESIDENTIAL x'� r,v _ARONLY e:1 AT1700 %,OFTTVVALUE?.�,r" Date sign 1d t�f -_; V/1LUE.u'zs Land not exceeding 1 (one) acre immediately s.'F�',^ee., r". r'k ) surrounding residential improvements. 1°'. Other land (2) •�^n � . Total land (fine 1 plus line 2) (3) Dwelling (4)' 'ax'a�'- Residential improvements or Anntragy..JJJ�u- Aasessed Mobile I Manufactured Horne Garage ..... f �v �! (5) Other improvements (6) Total improvements (line 4 through line 6) (7) Total value (line 3 pits line 7) (6) 1 hereby certify the above is true, correct, and Signature of Assessor Date signed complete. Verifying action - Signature of Auditor Date signed r- VpY", STANDARD. DEDUCTIONALLOWANCE Yc. 20_Pay 20_ Lesser of 112 Homestead $ 1I9I18Udn or 535.000 Signature of Auditor AU Date sign 1d t�f U •n MIT FORM!)Air 5-0.1 TlASUnnR FORM:ltA APrRTWU,BY RATE BOW)OF MYYYITS.a, 191MFaaa BY mu DEPARTVENT OF LUtAL CAT?LNMET'i FINANCE IC 11-1.1-2:4,1 Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and married couples are limited to one homestead sandani 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. HEA 1344--2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filings.This information will be kept confidential and©n only he accessed by authorized county officials.The l)eparment of Local Government Finance will use this information to create tool,that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name' Properti Address Melton, Brian ULori A 1015 4th ttrIS117 41 0 1730 Brian L Melton 107 S 4th St State Parcel Number Legal Description FRANCISCO IN 47649 26-13-19-202-000.091-005 012-00091-00 OLD PLAN 46PT -- - X 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. PART 2:TAXPAYER INFORMATION Owner I First Middle Last CLAM M,/T On 1 •tg Address(number and street,city,state,and ZIP code) Ei Same as property address Le IN\ rc1 c1eCC, SA-i 2171.0 yG Spouse First Middle fast ` 0c— Mailing Address(Number and street,city,state,and ZIP code) Same as property address PC &PC (_ 110 m6Sc Jyo 4'76 L9 PART 3:CERTIFICATION --Each undersigned certifies,under penalty of perjuy.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. Owns 1 tgnan t , I Date PART 4:ADDITIONAL INFORMATION •