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IMPORTANTaNOTICE TO HOMESTEAD rP PROPERTY COVERNMEICT FINANCE IC 4-1.1-2:4 l
Gibson County Auditor
101 N Main
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 ever for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to rreene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings_This information will he kept confidential and rte only be accessed by authorized county officials.The Depanment of
Local Government Finance a ill use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
2203 I:Lake Road
Princeton IN 47670
3361
State Parcel Number Legal Description
Princeton IN 47670
1(26-12-08-402-002.849-028 019-02849-00 PT SE 8-2-10.39 AC
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
go
FOflM HC 10 7979
PrescriGed 8y Sute BoarE ol Ta� Cammissioners
CLAIM FOA HOMESTEAO PROPERTY TAX CHEDIT FOH YEAR 19�
To & FIM in Dupliwte
/
I, (We) C�owned a�-�a n� y�a.�a�9�ag
❑ are buying under contract
❑ have a beneficial interest in the taxpayer , n
Property Description in ��w County '1"'� Township
Taxing District (City, Town, Township): 'i�r�-�-��^ Q�;x. /0
Parcel Number or legal description shown on tax statement:
. /�t 5�� ���f �-1-/ 0 3 i�
If buying on contract: Owners name �'� ""'ae °"'"e`�
Contract recorded in Recorders Office - Record
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.
�.
County Township
L
ana
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 �e) �cre �nmeq�ely�
surrounding residentia imprc�vemeH�S ��
Other Land
Total Land
.;UN :: G 1979_
Residential Improvements„ / / �Welling
ti/� L/
��� � � � v`,�'x� arage
AUDITORTotal
Other Improvements
T�±Improvements - Line (6) plus (7) equals (8)
i. by certify the above is true. correct. and complete.
Asse550r
True Cash Assessed
Value Valuation
(�) %�%�'
(2) —
(3) 1S [� O
(a) �P
(5)
(6) /
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(g) Y �
�ib�[ia �Li�1H�[i]:�
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Homestead
Valuation
J ZD
,5'-/7 -74
Da:e
Date: � 9