Homestead_Stoll " .
SIAIEF ORM IltrAS1ACR ItZIA
A/PWAEn BY ST AIL!UN!UNROOF MYR:NI t_1m PlaSRtam BY TED EP.ARI ME NTOF LO CAL CAlc0.YVir1.T MANCE M1.I.1-L`JI
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 nee for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HE.\ 1317-2009 requires taspayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to pmcide additional identifying information necessary to allow NUM government to better monitor homestead
filings_This information will be kept conlidernial and can only he accessed by authorized county officials.The Department 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
Stoll, Anthony M/Mary J
1704 Cottonwood DR
Princeton IN 47670
2356
Anthony M/Mary J Stoll
1704 Cottonwood Dr State Parcel Number Legal Description
Princeton IN 47670-3326
A 26-12-06-401-001.694-028 019-01694-00 NORTHBROOK HILLS 43
tit Ir I ru III I I t I I tit I t I t I I a I I tot I n I I II I I n I I II n
PART 2: TAXPAYER INFORMATION
Own I First Middle 6 I f Last
r\ 4—C\ Mac/L '
- —®ig Addr s(uantbe and 'ct.reit)7statc,and ZIP coda) - — ___ -.— _ _ __ tyCOm.tic property address __
$
Spouse First Middle Last
al'_ . Saync I �
Mailing Address(Number and street,city,state,and ZIP code) p Same as property address
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
sk
�'`�"`°- CLAIM FOR HOMESTEAD PROPERTY TAX
i � CREDIT/STANDARD DEDUCTION
�� �i�� State Fortn Sa73 (R2 / S92)
.��'
INSTRUCTIONS: See reverse side !or /iling instruclions.
FORM YEAR
HC10
CERT CATI STATEM T - i't �i"� '
I(We) certify�hat on the�ls�fday of h, 19_
I(We) occupied as our principal pl oi residence the followin �bed real property for which a Homestead Propp� 7attGCedifdeitereby claimed:
fU'R � � LUUU
❑ I(We) owned ❑ Are buying under contract .
❑ Have a beneficial interest in the entiry that is liable tor ihe property taxes on the property and that owns ih opeity �or is under n ct.
� n�i�vJ--✓1-:1- -
CONTRACT RECORDED /� '.- ' "'�::'+-�' ��'�- � �
if buying on convact, Fee Simple ownets name �
Recordefs oKce where contract is recorded � Record number Page
PROPERTY DESCRIPTION
Caunry � Township Tadng tlistrict (ciry, town, township)
p I 6erQ Legal tlescription
�
If any ponion of ihe residential structure or ihe land not ezceeding one () acre thai immediatey wrtoun s Uat sVUC[ure is use0 to protluce i�ome, tlescnbe the use a� portion of
ihe praperry utilized to D��uce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County Township Counry TOwnship
Sig [ure tda ni
�ereby certify the above statemenis are true, correct and complete. I
Atldress (number an stre ., ciry, sta• , Zl�e) '
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(oneJ acre immediatety (��
surrounding residential improvemenis.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvemenis
Garage (5)
Other improvements (6)
Total improvements (line 4 th�ough line 6) (7)
Total value (line 3 pfus line 7) (8)
I hereby certify Ihe above is irue, correCt, and Signature of Assesor Date signetl
wmplete.
Verifying acuon - Signature of Auditor Date signeA
� STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 — -
Lesser of 1/2 Homestead S
Valuation or 52,000
Signature ot Audiror � Dare sign � oO
_ �r� _ _ � �