Homestead_Bane o - 4 ,
stV E FORM.3 VAIP_r vwt TREASLRIR FORM TS-IA
APPPm'ED FIT 5ME MAIN Of 4,44MN14 an, PPESl1EBFD BY ntE DEPMTW`T OF LCRAL r1nTr trwt FQ:MCE IC G.T.4.S4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standanl deduction.As the receipt of this deduction Latuntes
more beneficial,there is more incentive than ever for homestead fraud.Ilomestead fraud causes higher tat bills for all:therefore.
®\ HEA 1341-2000 requires taspa)ers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying infomrat;,on 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 Ikpanment 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
_ Bane, Barry N
RI Box 136-a
Patoka IN 47666
946
Barry N Bane
4594 N SR 65 State Parcel Number Lesal Description
Patoka IN 47666
26-05-57-089-000.023-017 009-00023-00 PT MD 89 1-10.68 AC C-1
PART 2:TAXPAYER INFORMATION
Owner I First n Middle Last
/ ei c r / V ` cc LL `Qi
— -�tg Address(number stTct.city,state,amt ZIP code) - -" - - '-""n Some m-propelty rddnss— -— - — —
Y591 Ns76 5 0:: .- to (c5 -2=-1 . 6/ i (, 6
Spouse First Middle / Last
c5-4n pr es v /' 4r K -a-..
Mailing Address(Number and street city,state,and ZIP code) 0 Same as property address
Y5 9V A.) SR L S a, To (c5 _Z 1 , 99e) 66 6
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjuy,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 aturc Date
PART 4:ADDITIONAL INFORMATION
•
Te5CrJ.L)eu Eby 0L.aL.c 1MSlu ... . w..........«..
CLAIM FOR H01'ESTFAD PROPERTY TAX CREDIT FOR YEAR 191#
SEE BACK FOR FILING INSTRUCTIONS
LgetiVtAi 71--. certify that on the 1st day c
.111711, 19 p1, I, (We) dccupied as oar principal place of residence the following described real
Petty for which a Homestead Property Tax Credit is hereby being cta;, :
1
I, (We) Er8kmed •
El are buying under contract •
0 have a beneficial interest in the taxpayer
grope ty Description in / o A/ County (.344514 . Townshi
Taxing District (City, Town, hip)
parcel Number • or legal description shown on tax statement:
If buying on contract: Owners name (fee simple owner)
Contract recorded in Recorder's Office - Record ND. Page.
If any portion of the residential structure or the land, not exceeding one (1) acre that
imneiiately surrounds that structure is used to produce income, describe the use and portion of
the property utilized to produce income
Pny other counties in which individual owns or is buying real property: County . . -Township
ereby certify the above statement is true, correct and corplete.
*Signature Street Address • City, State and Zip Code
*Individual either owns or is buying uner 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 -
• True CCch Assessed Hanesteai
Value Valuation . Valuatioi
surrounding not cresi.ddeenttialnimproverenurmediately (1) S0.0 / 70 . ��/70
1A
Other Land (2) — — fArI9A/
Total Land (3) SOO / 7o /�����/,
Residentiallnnroverents Dwelling (4) 3444-oo /D//////%%%%
Garage (5)
Total (6) 3a¢ oo /0g00 /0g00
Other Iirrorovenents'
(7)
Tc Inorove tents - Line (6) plus (7) equals (8) (8) 3a4 GO /0 g00
I hereby certify the above is true, correct, and oanplete.
�!'rSiunature of Assessor Date
- ACTION BY AUDITOR -
Approved:
Date: