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Homestead_Smith (53) :FATE rots!Kt.IR:/',PI TRFASUtti FORM iStA .APPROVED BY,1 RTE BnsRO Of ATT*,•T%.9v PFFARmw BY THE DE/AREM_Y,OF LAVA'c tMstmT Fm'AYCt leeI.t-2-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 standani deduction.As the receipt of this deduction becomes ••, more beneficial,there is more incentive than ever for homestead fraud.Ilontestead 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 recehe 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 Department of Local Dovcnunent Finance will use this information to create tools that will help comity officials eliminate homestead fraud. PART 1: PROPERTY LNFORMATION Taxpayer Name Property Address _ Smith, Juanita 1208 S Gibson 1 Princeton IN 476"r 3879 Juanita Smith 112E 1st ST State Parcel Number Legal Description HAZLETON IN 47640-8808 �t� �uu��uI �n�t�� X26-12-18-203-002.661-028 019-02661-00 SS ADD 130 nllntltilutlnill iu ltinit llruln / r �'e-ancems PART 2:TAXPAYER INFORMATION . Owner I First Middle Last �uamfl .20 ma 'm ,QA_. ��g Address(number and street,city,state,and ZIP cod�e)/ f -- - -- - - _-- Same as propcny address- -- //a2 e. ,PS/ 5 f/ /eeon , /// 1-i ‘yo Spouse - First Middle Last Mailing Address(Number and street,city,stale,and ZII'code) 0 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) see 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. Cr I Signature / fate FOFA7 HL 10 1979 io Be FileE in DuD��ate Presc�ibea By Staie BWrO at ia. Commissioners CLAIM FOR HOMESTEAD PjiO�i�TY TAX CREDIT FOR YEAR 19 � 9 � 10 $�jBA�i��OR FILING INSTRUCTIONS 419� Q � �i �'' �� . .�1 � , n •� .� We) ��"^-�-�"- d certify that on the 1st day of �warch, 19—��, I, (We) occupi ou p ncipal lace of residence the following described real property for which a Homestead Property Tax Credit is hereby being claimed: ' I, (We) LI owned . � are buying under contract ❑ have a beneficial intere/st in the taxpayer Property. Description in lri 6 S mu ounty �� 'A Township Taxing District (City, own Township): �/i-c�-c-c�� Parcel Number or le9al description shown on tax statement: S S A�,4�� / 3 0 If buying on contract: Owners name �'ee "'"o1e °'""e" - Contract recorded in Recorders Office - Record No Ii 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: County Township � hereby certify the above statement ��..� n��. true, correct and complete. �G� � Ciry. S�a:e ana Ziv �e 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 1(�) �re i�edi� surrounding residential improveme � Other Land �U� � Total Land � � 1979 Residential Improve Dwelling , , Garage AUDITOR Total Other Improvements T '�' Improvements t�by certify the Sg�mre ol Assesw� Line (6) ptus (7) equals (8) Zove is true. correct. and complete. True Cash Value (1) d�3� (2) �3) �S?� �:L' � �r� • � �� : •• - ACTION BY AUDITOR - Assessed Valuation / $o � / 80 B Homesiead Valuation • �jj/�j�j/ �� —iz�9 oa,z Datei�� l9 7 9