HomeMy WebLinkAboutHomestead_Tenbarge SIAM FORM 11N.I IC I fug TE45U[Ea Fl/LM 75-1A
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Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead atandaal deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud_Homestead fraud causes higher tax bills for all:therefore.
•. HEA 1344-3009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe 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 can only be accessed by authorized county officials.The Department of .
local Government Finance will use this information to create tools that will help county officiary eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Tenbarge,Anita E
R2 Box 31
Haubstadt IN 4763
9430
Anita E Tenbarge
516 W SR 65 • State Parcel Number Legal Description
Haubstadt IN 47639
26-22-01-202-000.404-009 013-00404-00 PT E 1411 .275 AC
PART 2:TAXPAYER INFORMATION
Owner I AA First Middle Last
4f11 7L-C E /e h ka rj-e.,
- —
0,Address(number and street,city,state,and ZIP code) — -- -- — — ---0 Sarno as property address - - -- —
\ .
Spouse First Middle Last
Mailing Address(Number and street,city,state,and'LIP code) g 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)
sec=
PART 3:CERTIFICATION
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.
Owns Signature Dot
( )
PART 4:ADDITIONAL INFORMATION
40
-CLAIM �IOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 2
SIC- ti3/p�/S�E�E�r�BAC %K FOR FILING INSTRUCTIONS
O/3 do g5(-00
I, (We) mr'g' ' "- �QY1�ti>z- ---- --- ..- -- -_._ certify th,rt on the 1st day of
faarch, 19 (We) occupied as our principal place of Tesidence the following described real property for
ich a Homestead Property Tax Credit is hereby being claimed:
I, (We) E3"owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in County Township
Taxing District (City, Town, Township): _ H a x"61=
Parcel Number or legal description shown on tax statement:
If buying on contract: Owners name (fee Simple owner)
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: County Township
I hereby certify the above statement is true, correct and complete.
Jnern eamess
city. sure and ZT code
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 -
Assessed Homestead
Valuation Valuation
(070
I�
True Cash
Land not exceeding re m} d lely ,
y
Value
surrounding residentia effi
11)
Other Land JUG 2 1989
(2)
Total Land
(3)
Residential Inlproveml y,& YY1�S
0 Dwelling
Iql
AUDITO'R-.
—
Garage
(5)
Total
(6)
Other Improvements
(7)
Tot provements - Line (6) plus (7)' equals (8)
(8) —
I h _ .y certify the above is true, correct, and complete.
S,gnztore of nsse,;.,
ACTION
BY AUDIIOR -
Approved:_ A N1/vISL_—Ct— 02l
Assessed Homestead
Valuation Valuation
(070
I�