Homestead_Roy J.
StArt FORM 3M IL'/��rl TRE.4NarR m101175-I.\
.APPROVED BY A4R IXIARD OF AMOUNT,.9w PAf IPFD BY Tilt DEPARTMENT OF tWAL GOVERNMENT MWANCE MH.LLJI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than on for homestead fraud.I lomestead fraud causes higher tax bills for all:therefore.
• HEA 1348--21N19 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receise the
benefit and to provide additional identifying information necessary to allow counts'government to better monitor homestead
filings.This information will he Lept confidential and can only he accessed by authorized county officials.The Ilepanment of
Local Government Finance w ill use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Roy, Patricia
241 S Ilan
Princeton IN 47670
2867
Patricia Roy
241 S Hart State Parcel Number Legal Description
Princeton IN 47670-2125
�t�tt��rrt�r��rr�rtr��� �r�ttr��tt�t�t�t�t t�rt�ttr��rtt��� 26-12-07-302-002.892-028 019-02892-00 OLD PLAN 1 PT
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PART 2:TAXPAYER INFORMATION
Owner I First Middle —' Last
•
g Adds'. a(number and strccL city,sttw,and ZIP code) - J Same as property address -- _. — - - _-. .
cQ'l $a Moat •-- - tncc7o0 N
Spouse First Middle Last
J f-SOn UJ �yre ID
—
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(p1 a specify in Part 4 below)
Sere
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.
Owme thtb turo Date
.�•n•>•, CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
d -k
:� � : CREDIT/STANDARD DEDUCTION Hcio q0,
:� State Form 5473 (R2/1-90)
�'°�• � INSTRUCTIONS: See reve�se side lor �iling instructions. - /
-��-q � � CERTIFICATION STATEMENT v
I(We) (�i,S.aASl,o_ certify�hat on the 1,sCday of March , 19 ��
�; We) occupied as o principal place of residence the following described real property for which a Homestead
Property Tax Credit is hereby ciaimed: �[�i'(We) owned ❑ Are buying under contract
� Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
property or is buying it under a contract.
CONTRACT RECORDED
If buying on contract. Fee Simple Owner's Name
Recorder's office where coniract is recorded Record Number Page
PROPERTY DESCRIPTION
County
town,
v � �' L]a5 u � cs i � i.a.cr v_.v..�. •— v,aw�,.iv � � Q—
If any portion of the residential siructure or the land not exceeding one (7 ) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of ihe property utilized to produce���, �, �
County
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
cenify the above statemenis are true. correct and
Address
ASSESSOR USE ONLY
state and ZIP code)
�'
TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
NON-RESIDENTIAL
VALUE
Land not exceeding 1(one) acre immediately
surrounding resideniial improvemenis (�)
Other land (2)
Total land - line (7) plus line (2) (3)
Residential improvements Dwelling (4)
Garage (5)
Other improvements (6)
Total improvemenis - line (4) through line (6) (7)
Total value - line (3) plus line (.7) (8)
I hereby certify the above is irue, Signature of Assesor Date Signed
correcL and complete
Verifying Action - Signature of Auditor Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990 1990 Pay 7991 I 1997 Pay 1992
Lesser of 1/2 Homestead �esser of 7/2 Homestead Lesser of 1/2 Homestead
Valuation or $2,500 Valuation or $2.000 Valuation or 51,500
19—Pay 19—
Lesser of 1/2 Homestead
Valuation or �1,500
Signature �f`Puditor � ' M 5te
� 1 Mn-� 0 � -�-�Q l�