Homestead_McIntosh SIMIE FORM!)!-ln_'l,IPO TRFASULER rOEN IS-IA
APIR(n'EO BY STATE WWII)Of fir R NTS.is rr1YTlBED BY NIT DEPARTMENT OF LOCAL CrOVttNMENT FINANCE lr.-th-sI
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
i
more beneficial,there is more incentive than C% u for homestead fraud.Homestead Fraud causes higher tax bills for all:therefore.
HEA 1 344--2009 requires taxpayers who receive the homestead standard deduction to serify that they are eligible to teethe the
�J �, d
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 he accessed by authorized county officials.The Depannent of
Local Govcrmment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
APR 2 2 LUlU PART 1: PROPERTY INFORMATION
— �-y,, Taxpayer Name Pro'erte a Ir ess
G'fa /435%-e McIntosh, Homer Lesley/ Debra A
— GIBSON COUNTY AU: -i: /'a R2 Box 55
Oakland City IN 47660 4,
2110
Leslie
Homer Lesley/Debra A McIntosh
Oakland 46- I i 4 98 169 0100 Seal L7 State Parcel Number LeEal Description
Oakland City IN 47660-8169
26-14-19-104-000.611-006 003-00611-00 CAPT MCCULLOUGH
I n II t Ir II t II II 1 I I t t II t II I t I I I I I I II I
9P1\10PT 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
Homer L e Les '\�" I tih+DS "
•w Address(number and street.city,state,and ZIP code) 9 Same as property address
11898 Eas± zoo Sote(A Qc41 &r,d C -14y , iN q7GGO
Spouse First Middle Lau
DCbrA- AP1n MC Zh+DSA
Mailing Address(Number and street city,state,and ZIP code) ® 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 S' nature ( Date
• —
a AIM FOR RESM PROPERTY TAX CREDIT FOR YEAR 1985 -
SEE BACK FOR "FILING INSTRUCTIONS
certify that on the 1st day of
19 i, ) occulu as our nal place of re residence the following described real
��erty or a HcumteW Property Tax Credit is hereby being claimedt
I, Oft) i 00 QD
p are buy�in tinier contract
I] have a beneficial icier i
interest n the taxpayer
Property Description in County Township
Taxing District (City, Town,
Parcel Ihmiber or legal description shorn on tax statecwnt:
If buying on contract: Owners name (fee side owner) �� � i 9 �� 7 ''�O� L Cx�
Contract'recorded in Recorder's office - Record No. Page
If any. portion of the residential structure or the lard, not exceeding one (1) -acre that
immediately surrourds that structure is used to produce inoBne, describe the use and portion of
the property utilized to p=kbice itnome
Pny other counties in which individual owns or is buying real property:,: .Counti:....
I hereby certify the•abow torte ent is .true, correct and couplete.
*individual either owns or. is buying uner a contract that provides he is to pay. the
property tames on the residence, or has a beneficial interest in the taxpayer.
ASSESSORS USE oNLY -
�' True Cash
Value
Land not exoeeding 1 (one) acre immediately"
surrounding residential iRnovenents
other Land (2)
Total Land (3)
Residential Inprovemer" pwelIIM '(4)
Garage
..
(5)
(6) $ ? to
(7)
To IjTVzova ez*.s -. Line (6) Plus (7) equals (8) (8)
I hereby certify the above is true, correct, and oaplete-
Assessed
Valuation'
!7o .
Homestead
Valuation
/.7.0
Date
(�• - ACTION BY AUDITnR
�T l J^ft Date: (i -
uigroved: V