Homestead_Renfro llAtE FORM 53!MIR_r uMl TRLSUuQ Ka TVj,L
AIIRovEO MY tt\TE BOARD rWXTYR L\T%.9Y Ptf3(WBm BY nn DErAa neeTer IsEnt nOVEPenler Fa:A\CE ICVI.1"A,I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 1 3462009 requires ta,pa.scrs 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. Ibis information will he kept confidential and can only be accessed by authorized county officials.The Depannient of
Local Government Finance'sill me this infomotion to create owls that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Renfro, Amy
917 S Jefferson
Princeton IN 47670
3582
Amy Renfro
917 S Jefferson State Parcel Number Leal Description
PRINCETON IN 47670-2709
Irlt Fllll Jlrrll Iirt tirl littrllitttrtltrrtr Ilrrtilltr tl 26-1217101-000.187-028 019-00187-00 KUNKEL ADD 42
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Anil/ • L . Revg-o
�g Address(number and street,city,smtc,and ZIP code) — _ —-- ®
Same as property oddresc — — — —" —--.—
G t rl S . d errciaconj S i KeTT-
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) El Same as propeny address
Social Security Number(last 5 digits) Driver's License/State ID Number (lase 5 digits) Other(please specify in Pan 4 below)
sate
_ _ . _ . 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 I Signature I —' I� . .i ` Flats
0
y`as� CLAIM FOR HOMESTEAD PROPERTY TAX
�, CREDIT/STANDARD DEDUCTION
State Form Sa73 (R2 / 5-92)
�� ,�i
INSTRUCTIONS: See reverse side lor liling instructions.
FORM YEAR
HC10 � — I'� L
r� ��— ..
I(We) \� .l4_�n.�..l certify thai on th st day ot M�ch, ���
I(We) occupied as our , ncipal place of residence t e following d scnbed rea roperty for which a Homeste�ad Properry � GIBSO�' �Efv�.�a ��mg'd'
�(We)owned ❑ Arebuyingundercontrad q%—G-6� Q(:.�5/
� Have a beneficial interest in the entity ihat is liable tor the property taxes on the property and that owns ihe property or is buying under a contract.
� . ' . - . CONTRACT RECORDED:�. . .. � ti �. � - -. 'a:?i-.'
If buyify on coniraa, Fee Simple owner's name
Recorder's oflice where comract is recordetl Record number Page
County
Parcel number
TownShip
PROPERTY�DESCRIPiION . �' -�
iarPB disMd (cify, rown. township) '
.� t i- c--� �� i^ ea i
If any portion of Ne resi0enlial swcture or ihe land not exceeding one (1) aae Ihat immediatey surrounds thai structure is used ro produce inmme, describe Ne use arW portion
of the property utilized to protluce income.
. � ASSESSOR USE ONLY -� TRUETAX - ASSESSED NOMESTEAD �. NON-RESIDENTIALr�
� � VALUE VALUE VALUE - VALUE �
Land not exceeding 1(one) acre immediately �-'� � �
surrounding residential improvements. (�� � - �
�n:
Oiher land (p) � '
e�. �
ToWI land (line 7 plus line7) (3)
Dwellin9 (d) .. ' ' � - �
Residential improvements . ,
Garage (5) �
Other improvements (6) � �
Total improvements (line 4 Ihrough line � (7)
7otal vaiue (line 3 p�s line � (g)
I hereby certify the above is true, tOrreCt, and Signamra ot Asseswr Date signed
complete.
Verifyirg aaion � SignaWre of Autlitor Date signetl