Homestead_Fish 'WE FORM 3,*lR.IW.I MAMMA FORM:}IA
AFLAME°BALLO!V5sRDOF ATI*INT.L!oo MAIMED BY ME DEPARTMENT OF LOCAL foVtr Mrwi FS<ANCE MV[1=V.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 IndividuaLs and married couples arc limited to one homestead standard deduction.As the receipt of this deduction bccontea
` more beneficial.there is more incentive than eser for homestead fraud.homestead 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 receive the
�I benefit and 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 comity officials.The lkpannent 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
Fish, Steven L
RI Box 41
akland City IN 47660
1666
St en L Fish
202 N 1050E State Parcel Number Legal Description
01 KLAND CITY N ,660-8621
l 26-13-12-100-001.406-006 003-01406-00 PT SW NW 12 2 9 2.00 AC
r t l I I I I t I I I I t I I I I I III I t I
C-1
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
S-�2V2V1 L-OWtil C1 ski
(ling Address(number and street,city,state,and ZIP code) Same as property address
'102 N. ID5o E OcWIand G.-k( • 4-11,t,o
spouse First Middle Last
CYin l vll? L(P ifs'
.s4
Mailing Address(Number and street,city,state,and ZIP code) Same as prupeny address
20 N. 1056 . Oae(and &]-y IN 4-1//lea
---
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 IISignanne Date
CLAIM FOR HOMESTEAD PROPERTY TAX gG FORM YEAR
CREDIT /STANDARD DEDUCTION Hc�o
Slate Form 5173 (R614-03)
Prescribed by the Department of Local Government Finanoe
INSTRUCTIONS: See ravom dcb bGSrp ntbucdom
I (we) a cerN�t licit an Te�i415bday of March, 20
1 (We) occupi as our principal place of residence the following described real property for which a Homestead Property Tax redit is hereby claimed:
❑ I (We) owned ❑ Are buying under contract
' Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is�twying under a contract.
'` �$ 1n ,'a'`sC_ONTRACTRECORDED "z°�.rr
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
rti�` -t`a. 'K.(% �' 7 : cif• ' !. t�.` _ fiftOP,ERT.Y, DESCRIPTION �"`'
.Y.. -. v.,a6u_ ,...'S �L ..f✓'J zC.53�ss"r'Y 1y�t�,c
County
Tit nstup
Testing district (dry, fawn, township)
Pa I m r
yob
Legal 'pti
W -a
is the property in question.
❑ Real property ❑ Mobile Home ( /.C. 6- 1.1 -7)
H 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 properly utilized to produce income.
.-r s a' � ^s it =��'-t �
yASSESSOR USE ONLY }rO' RK
County
Twvnship
County Township
I hereby certify the above statements are true, correct and complete.
Signature of aimant
§d ss (number and shear, city, state, ZIP code)
U 4 oler, .41 (, CJ
.-r s a' � ^s it =��'-t �
yASSESSOR USE ONLY }rO' RK
l
TRUE TAX , ,,
ASSESSED VALUE
c HOMESTEADS
_
k N- RESfDENTIAL
,,,as,"','
rVALl1Er._
.,ATt100 %.OFTTV,VALUE,{yF'
VALUE'.�y'�
Land not exceeding 1 (one) acre Immediately
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)"-
,. "
W
'Residential Improvements or Annually
`^1ne`4'� "
MaeaNd Mob6e I Manufactured Horne
Garage
5
_
Other improvements
(6)
v
Total improvements (line 4 through line 6)
(7)
Trial value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
.- STAN6ARD'. DEDUCTIONAL' LOWANCEt +;',- IS`- k�.:�.y'pskzy'5'n�,r
20_Pay 20_
Lesser of 1r2 Homestead $
Valuation or 535.000
Signature of Auditor Date signed