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Homestead_Brittingham (4) CLAIM FOR f PTEAD PROPERTY TAX CREDIT FOR YEAR 1��. SEA liACK'FOR F�L1NG'1NSTRUCTIONS . _ 1, ,.1e) 7 ' Y //i • i ,, /�ij _/_ ,..� certify that on the 1st day c `,,perry or i. /a {1onisieed Property Tax Credi rim tarty being following described seal 1, Me) 51 owned .• ❑ are haying wader contrast • phase a brnetla.at in the taxpayer Property Description. is _ County Siste;isiraenatLi Texing District (City. 'Dow:, 'JUraship) i - },(f Parcel nutter I I I . or legal iption stow, on tax atatesant, I &.�J1 4 ?//- 9 see . If buying an contract, Owners name (fee simple owner) Contmotlecordedin Recorder's Office - Record Pb. Page If any particle of the residential structure or the land, not exceeding•one (1) acre that umatiataly surrounds thou sttvctaas is used to produce incase, describe the use and postman of the property %milted po paoduos intone • Any other counties in Which indivddual owns or is buying real property, , minty : Township 1 .A— . pawn ctatecent is true, correct and complete. ........... ever 4 - • .t -tura / • Street :. ..: - .• ty, State • Code v •individual either owns or is buying user a-contract that provides he is to • .,� the puaperty. terse = the residence, or has a beneficial interest in the taxpayer. . - FOR ASSESSOR'S USE ONLY - True Cash- Assessed Haoesteod �- Value Valuation .. ' al a� Lail rot exceeding 14 s�rely (1�p 17* --, f 7t r urroiu,iinq umber Land - (2)1" - 9c ?/%�///� Total Lard •. Y I� •to-'3 (3) 4 g b 2.1..r, '.. �o ' ///����//� )atsidantial bipgoveerib `„ {.4-= '1 '' (4) T_—•• 7-Al%' . 0://S/' �g IRL�( ' ' Garage (5) ///%/." 4 :',////%////// Total (6) ?- 9a. 8o ?no ' 77g1,- uu.�r lnprovects • (7) /%,///%i 'to • lnprovsz . - Line (6) plus (7) equals (8) (8) //%/%///1 I thereby certify the above is true, correct, and complete. . '7nat ue oUMaeeaar °a`" . - ACTION BY AUDITOR - • • Data; $"- 9- 5 . . • STAIt FORM!ffir,. cr 4nr rwASUAEA FORM 11-IA • .APrMWEO BY MIL IXND OFM«tTTs.9v ryEYWBW BY nil'Brant terr{*LfxAL Gn'ctNMrKT FINANCE le fJ.braI 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 more beneficial.there is more incentive than mgr 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 am divide to recent the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filmts.This information will he kepi confidential and can only be accessed hr authorirnl county officials.The Depanntem 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 Brittingham, Ray/Marilyn 6670\V County Rd 50 S Petersburg IN 47567 1123 Ray/Marilyn Brittingham 6670 W County Rd 50 S State Parcel Number Legal Description Petersburg IN 47567-8108 - - 26-06-21-400-000.055-017 009-00055-00 PT SE 21-1-9 5 AC I,I1•II11tLltLtil� L;rII1 It 11IIIt iI tliLailL�Jaill — — — — "----- -c-1 —. -_ PART 2:TAXPAYER INFORMATION Owner I First Middle Last 24 ��osg r�t MAU84� • •g Address(-number- street,city,state,and ZIP code) - - -- -'- 74 Same as prupertr u dst a - 667o U1 . CD . 2d . sys Spouse First Middle Last "7Aei l y L Bali' 6 l/y A111 Mailim Address{Number and street,city,state.and ZIP code) 12- "ne as property address Zt 21) t cb en/ sf, s 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 'he may be liable for back taxes and substantial financial penalties. Owner i t e Date PART 4: ADDITIONAL INFORMATION •