Homestead_Scott (3) STATEFORM.•J5 IR:/!!x! TRF.1SUEEA FORM 3.IA•
.ArrKm'EO BY SP&L DOsRD OF NYYMiN71C.9x InsCIMW BY Till OLPARTML:OF LOCAL rosa''Mrn'r FINANCE h'6-L1-_+.I t .
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 eser for homestead fraud.Homestead fraud cause higher tax bills for all:therefore.
41 HEA 1344-2009 requires taxpayers who remise the homestead standard deduction to verify that they are eligible to reeene the
benefit and to provide additional identifying information necessary to allow county gmrrment to better monitor homestead
filing.This information will he kept confidential and can only be accessed by authorized county officials.The Depannsent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Scott, Michael K
525 W Illinois SF
Princeton IN 47670
1405
Michael K Scott
525 W Illinois State Parcel Number Legal Description
PRINCETON IN 47670-2311 -
II III 'nIII ' I I I II II I I I I III 26-12-18-101-004.266-028 019-04266-00 PRINCE PLACE 78179180
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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
lc , Scar
�Tg Address(number and street,city,state,and ZIP code) Same as property address
ar W. 1- ET /? Nc ero4 r.) 1/ 76770
Spouse First Middle Last
Mailing Address(Number and street.city.slaic,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)
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 'Date
t
�• , CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Slate Fortn 5473 (R6 / 1-03)
Prescribed by the Departmem af Local Govemment Finance
INSTRUCTIONS: See revcrse side /or /iling insfmc(ions-
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�a FORM YEAR
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JUN z.� 2ooa
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I(We) certi(y that'on.the 1sl.day,ofMarch, 20
'1_' � . q�cC(lni �^011��; v q� ,Jn., � .
I(We) occupied as our principal place of residence the following described real property (or which a Homestead Property Tac Credit is hereby daimed:
� I(VJe) owned ❑ Are buying under contract
� Have a benefidal interest in the entity that is liable tor ihe property taxes on the propeRy and that owns the property or is buying under a conVacl.
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If buying om m�tracl, Fee Simda ownefs name
Recordefs otfice where conVaq is recorded
County
Tavnship
town5hip)
Record number � Page
� a ej�scr�pnon �j Is the property in estion:
O�' � �.i./Yl/!�� �/�. � ealD�aDeRy ❑ MobileHwno(IC 67.f-7)
swdure w Ue land not exceeding one (t) aae that imme iatety wnounds ihat swaure is used b produca income, desuiba Ne use and portion
ce inmme.
1 4S � � `� �fU �3 � O �
�/ �- nn 7 �7 - m�
�'���='i��.�.3Tv . . .
_-ra: .�i"��'.�`�'„"i_?�dr..T�i',7'�`-3`9�.�`+.�:STANDARU;DEUUCTIONALL'OVJANCE u'-�".x"� " �
-'� � ��w...,.t�4'x't.:$a�;�.' aYi;,�?L�='f�..a.�s"�"-.����'s.'�>�k 'r�-u
20_Pay20_
Lesserof 1/2 Homestead $
vauaUOn or 535.000
Signature of Audhw ' Date signed