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Homestead_St. Clair (6) STATE FORM:1.1,000/5-4Pl MA-MILER FORM S IA • AFTOVRO by O set BmRDOF An•RN'tt.eun Ping,lnaD BY 111E DEPARTMEYter LOCAL GOVERNMENT FINANCE MFpt-r-,.l Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 101 N Main 1 PRINCETON IN 47670 IndividuaLs and married couples are limited to me homestead standard deduction.As the receipt of this deduction became ,71 more beneficial.there is more incentive than ever for homestead fraud_homestead fraud causes higher tat bills for all:therefore. — HEA 1344-2009 requires aapa)ern who receive the homestead standard deduction to verily that they are eligible to recene 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 ran only be aeceased by authorised county officials.The lyepanntent 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 St Clair, Lloyd T/Mary A 300 N Third AVE Princeton IN 47670 1551 Lloyd T/Mary A St Clair 300 N Third Ave State Parcel Number Legal Description Princeton IN 47670-1014 IIIII'IIIIIII'Il'Illlll iiii IIIIIIIIIIIIIIIIIIIIIII )( 26-11-12-104-002.733-028 019-02733-00 TOWER HGTS 80 PART 2:TAXPAYER INFORMATION • • Owner I First Middle Last P2/9 if y. /9. 5 r, �/ �4 i if - -�in Address(number and s a g er-c i t y;s a t e;a r T d ZIP code-- --- - - '11�t-Smrn m pry{ear e.lunsa ---— — — — — — — _.soo N. 17171t. ) /`90. PRl4CL-Tao/ fN' 47670 Spouse First Middle Last DEC EASE ---- Mailing Address(Number and street,city.sate.and ZIP code) O Same as property address Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below) 5= PART 3:CERTIFICATION Each undersigned certifies,under penalty of perjury,that the above and foregoing infonnation 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 • FOFM HC 10 79i9 Presaitea By Stal= Boara ol Ta. Commissione�s CLAIM FOR HOMESTEAO PROPERTY TAX CREDIT.FOR YEAR 19�� To Be FiIM in Ou0licate �� SEE BACK FOR FILING INSTRUCTIONS O(Q� D.�rT,33' O� �(We)�� T "°�Ri4'`1 � �'e`t'`'4� certify that on the 1st day of �larch, 19 �_�, I, (We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby being claimed: I, (We)�wned ❑ are buying under contract ❑ have a beneficial inter�st in the taxpayer Property Description in /-�+�✓ Cou�n/yq� � 4-4'�'� Township Taxing District (City, Town, Township): /�h� Parcel Number or legal description shown on tax statement: �rtc�-G✓ .Uy� �o If buying on contract: Owners name �'� �'^'o'e °"'"ef� 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: County hereby ce statement is true, coriect and complete. �J Snee� noeress Gi�v. Township ano 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(one) acre immediately surrounding residential improvements T�otal Land � � �g � � Residemial Improvemenls JUN 2. i979 True Cash Value (7) o�/ o 0 (�) rs� a�oo Assessed Valuation 0 �oo � ��`� -� Tolal Other Improvements � AUDI�� T�'�' -Improvements - Line (6) plus (7) equals (8) I�by certify the above as true. correct. and complete. - ACTION BY AUDITOR - �� n Homestead Valuation 700 z z �.,,,,� /979 Oare Approved: ,L�� — �,_ �� o�r� Date: _�- -Z �-7 7� '