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Homestead_Robb (8) STATE FORM 5150(RJ/8-10) 1Rr;AMMFa FORM TSIA APPROVED BY STATE BOARD OFACNUNTS,2009 -_ PRESCRIBED By TIIE DFPARTME\T OF LOCALCAVFRNMEYr FINANCE a:611224A Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud Homestead fraud causes higher tax hills for all;therefore. HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify 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 be kept confidential and can only be accessed-by authorized county officials.The Department of Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. ILE PART 1: PROPERTY INFORMATION • Taxpayer Name Location Address APR 2 5 2011 Robb, Gregory 329 W Brumfield C. .p Princeton IN 47670 2573 GIBSON COUNTY AUDITOR Michael A Robb IIDI 0111 mil 011010110Hill 011101011 II 1011 II 329 W Brumfield Ave PRINCETON IN 47670-1353 �II�FIIl�lF111IIIllI'�II�III�'I"Ill"�I"ICI"II��"I'lllllllll State Parcel Number Legal Description 26-12-07-103-002.692-028/ BROWNLEE ENLG 7 PT/8 PT 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. \7_1 '� Q {D' P=tRT_?:TAXPAYE.R_INFOR_NNATION • /,�� `'/ First Middle l� - - - Last —_ Mailing Address(number and sired city;state,and ZIP c e) O Same as pro ad Spouse First Middle Last Mailing Address(Number and street,city,state,and ZIP code) Same as property address Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below) I I? . I I I I I I I Stu • PART 3: 'TIFICATION 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. CLAIM FOR HOMESTEAD PROPERTY TN( CREDITISTANDARD DEDUCTION Slate Fam 5173 (R6 / 4-03) Plesaibed by tlro Departrnent of Local Cwvemment Fina�e INSTRUCTIONS: See re�erm akb b Bip iu�urbions. �\�� YEAR \ FORM 1 HC10 �(�'�e) — I``�� " certif�tN�t r+t� th tst d�Ma�h, �— I(We) occupied as our prin � pal pla of residence the foilowing described real property tor which a Homestea�rope�K ewy.aeimed: ❑ I(VJe) owned ❑ Are buying under contract' ""' '""'� � Have a benefidal interest in the entity ihat is liable for ihe property taxes on the property and Uiat owns the property �i L b�r 9?��5 a wnUact. I( byvg on conLaci. Fee Simple ownefs name Recorde/s ofice whare conUaq is recorded ?� �k���`.��.�'�''�?'�m�_.."�.`�����Fr�� Counry � Tamship u any ponim o� the res;aenua� saucn�re ar me wnd na of Ihe property utilized b prpfuce iMOme. County Tavnship (1) acre t0ac I hereby certify lhe above statements are W e, coned and complete. (numbei aM SVeet, city, sfafe, ZIP cade) Record number � Page Tating tlistrict (riry, mwn, {►operty in question: T❑ Real propeRy ❑ Mobile Homo (LG. 61.1-7� . that swcture is used tn produce income, desai6e the use and portion County Signature ol Gaimant {�� � �x'�`-y }'� F;� � ¢{��'����� �3"TRUETAX'� ASSESSED VAUIE �HOMESTEAD�� . '''NON=RESIDENTWL��. �� _ � �,�''-.,,g,,,Ev� p��� �-��. 'ii �� ���VACUE��� �AT 100%OF�TN� �� VALUE ���"' !`' VALUE �`"'' �' �s�i�, `-.- ,.rai�.a � £�- Land not exceeding 7(one) aae immediatety �-#�- ; � �f?"��.�{n, �: n �z: surroundingresidentialimprovemenfs. ��) �-,�,"`�"'O"4p��" .f�����', -�� r1..� �» Other land ( � �`� c �t � 2 s � � -�:r� f a '1z Tofal land (line 7 plus line 2) �3) '� Azs'4`�:'�` .. y�'s..eFi�� �a� Dwelling (4) "-�:� c �° �r �Rasidential improvaments or MnuaDy s'�����`� ' °' ��'�;' �"�'� Aase�d MobOe / Manufac4ned Home Garage (5) ��t�,`���- ���. .������ T ax„ `�� vd ���F�'i���� r � Other improvements (6) . - ]� , �.�,f .�i'.V.�+���1t�d� Tdal improvements (line 4 fhrough Irne 6) ��� T�tal value (Gne 3 plus line � (g) I hereby certify fhe above is W e, corred, and Signawre of Assessor Date signed complete. Verityirg aclion - Signature otlwAibr Date signed 20 _ Pay 20 _ Lesser of 1/2 Homestead V9uaLOn orf35.000 SynaWre of Puditn S )�{ pS