Homestead_Tate (5) ' e • Sriit FORM 53,0,11C/3-Ern TPFASUPLR Pn0.V 79-IA
APPROVED fit RVE IXWOOt AOMINTc. w PfLRMBM BY nil OEPARTILYT OF LOCAL QwELNMFWT FINANCE te H.1-2241
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and hurried couples are limited to one homestead sundani deduction.As the receipt of this deduction becomes
r more beneficial.there is more incentive than e'er for homalead fraud.homestead fraud causes higher tax bills for all:therefore.
HEA 1:44-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to rescue the
benefit and to provide additional identifvint information nett-sun.to allow county government to better monitor homestead
tilin��.Iltis information will he kept confidential and can only he accessed by authorized county officials.The Department of
Local Government Finance will use this information to create lids that will help county officials eliminate homestead fraud.
PART 1:PROPERTY INFORMATION
Taxpayer Name Property Address
Tate, Jennifer R
211 W Spruce
Princeton IN 47670
2477
Jennifer R Tate
211 W Spruce State Parcel Number Legal Description
Princeton IN 47670-1425
Il ltr'Itt tltllttltttill 11t1tr1rr 1r1r1nll lrl llnr tllt tlt il X26-12-07-102-002.831-028 019-02831-00 OLD PLAN 110
PART 2:TAXPAYER INFORMATION
Owner I / First Middle Last
jen n.r V e r rRa_c —7;4-6
•1gAddress(comber anu'sattt.city. a:czand ZIP cede) - _. - _ -._ _ 2.Same as property oddress—__ . . _- - .
/I W. Spruce Pr■ nCe'h n Z" 14- 7670
Spouse First Middle Last
Mailing Address(Number and street,city,state,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)
Sete
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is taste 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
•
fOflM HC 10 19i9 io Be FileE in Duplicate
Pre5cri0ea By $Ia:e BwrE o� iaz Cammis5ioners
CLAIM FOR HOMESTEAU PROPERTY TAX CREOIT FOR YEAR 19 �! ,/
SEE BACK FOR FILING INSTRUCTIONS p�g_ oa S3l -��
� ` ,1.� /�
�,(We) =�` '� � �- -, certify that on the tst day of
�vlarch, 19 % I, (We) occupied as our princ place of r sidence the following described real property for
which a Homestead PrqRerty T i i jrgdit_is_ hereby being claimed:
�� ��i 5
I, (We) � owned
❑ are buying under contract
❑ have a beneficial intgrest,in the taxpayer
Property.Description in —
Taxing District (City, T'ovsn�ewnsqi�): ✓1-�-
Parcet Number
If buying Ofl contract Owners name ��ee smoie ownerl
:ounty �Q-""'L °-� Township
or legal description shown on tax statement:
�?�p� � � o �
Contract recorded in Recorders Office - Record No
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:
��-hereby certify the above statement is true, correct and complete.
��� . D . �,� �
Street Aooress
County ' Township
Ciry. S:a�e ana Zio Caae
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) a¢J� i edi�y ��
surrounding residential improv�tenis
Other Land ��
Total Land
Residential Improvements
Other Improvements
J`j1V L`� ���:1
1 � )i
�� � �
/ .� ��•-
- Line (6) plus (7) equals (8)
above„is true. correct. and complete.
True Cash Assessed Homestead
� Value Valuation Valuation
. —_.,
( � � / % o—o
�o� — � —
- ACTION BY AUDITOR -
� 70
— o —
� � �
�o—a-o-79
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