Homestead_Roney (5) SIAM FORM!) •IR_/fwd tRtASURER FORM TI-IA
Gibson County Auditor APPROVED BY MATE BO'P m
O OF ACCOUNTS._ , PR SAJBEJ BY my DEPARTMENT Ewr(i LOCAL nOVERVMOR FINANCE Ie11.I.1-r4.1
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc 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 tax bills for all;therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit anti to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be accessed by authorized county officials.The Ikpanntent of
Local Government Finance will me this information to create tools that will help cvmty officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Roney, Richard P/Judith A
318 N Seminary
Princeton IN 47670
905
Richard P/Judith A Roney
318 N Seminary State Parcel Number Le2a1 Description
Princeton IN 47670-1830
IFIFFIIFFtIFllttlttt'll II'ttlttll�Ill 'IIF FI FF IFIII 26-12-07-203-002.439-028 019-02439-00 NS LOT 2 PT R1
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
-I- lone
Ong Address(number and street,city,state,and ZIP code) fr Same as property address
3 i Q /1O K7'k Ch-e e f�1 c,40,o / — — <7.7 6 7 0
Spouse II FirstI Middle Lao
�e c eaS eci
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)
sox
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. •
rf.'rler 1 Signature Date
•
wan� nc �o is�s
HescriMM By State Board ol Ta. Commissioners
To & HIM in Wplitate
- CLAIM FOR HOMESTEAU PHOPEHTY TAX CREUIT FOR YEAR 19�� �
SEE BACK FOR FILING INSTRUCTIONS Q�9- Qa�.3�' � �
�(We) ���x-�� �'�% ���- C. -�- certify that on the 1st day of
arch, 19� I, (We) occupied a our principal place of resi nce the following described real property for
which 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 �/-d-�.-'
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners
o.�en
��� Township
or legal description shown on tax statement:
lUS s,e/
Contract recorded in Recorders Office - Record No. Page
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:
�hereby certify the above statement is true, correct and complete.
County
0
Township
' 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 �ne�acre�imme$iatel�
surrounding residenti mp vemE'n�ts �,.`�--�-
Other Land
Total Land ,��N � s �979
Residential Improvements Dwelling
� � �����,��arage
� AUDITOR Total
Other Improvements
Tr• ' Improvements - Line (6) plus (7) equals (8)
I�by certify the above is true. correct. and complete.
Sigeu:ure ol
Approved
True Cash Assessed Homestead
Value Valuation Valuation
(�) 02�5�0
(2) �
(3) ��5�
(4)
(s)
(6)
(�)
(8)
�� l � C�7 ►� �: ��r �� 1� I f t�l i�
7S't�
oa:e
Date:
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