Homestead_Beach MATE I ORlI ).W Iri url Tar Mstn FORM}.IA
.APPnrn'ED0I'Alt WARD Of.enrNrs.2ow PLEStAIBM BY tar Drr,nnaVT OF LOCAL GOERNMrnra:ANCE le 61.14:41
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple,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.Ilomesread fraud causes higher tax bills for all:therefore.
• HEA 1374-2INN requires taxpafen who receive the homestead standard deduction to verify that they are elicibte to receive the
benefit anti to provide additional identifying infomuamon necessary to allow Bounty gin eminent to better monitor homestead
filings This information will he kepi confidential and can only he accessed by authorized county officials.The Depannent 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
Beach, Michael A/Laurie L
1t .s;ik-+N-4.7/1-4.. c I I
3272 601 M0.I/ 34r1e Li•
Michael A Beach MU �'9 / -7 76,5 9
R3 BOX 119 State Parcel Number Legal Description
OAKLAND CITY IN 47660-7724
I1ltllltltltlltlrllttlltttltttllrlllllllllllllll ll1ll11I 26-20-14-302-000.989-001 001-00989-00 PT NE SW 14-392.00 AC
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
N i c1vi t , Altar lead,
rig Address(number and sweet,city,state,and ZIP code) 111 Same as property address
g801 E '7o0 S Da.kland Ci-y 11\i 4-760(0o
Spouse' First Middle Last
L1wrle- L Loveless "Bead)
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
9 SD\ G loo S baklava e-lt 1 /N 1-176,400
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
unlaw full , e or she may be liable for back taxes and substantial financial penalties.
Owner 1 S oat Date
°
PART 4:ADDITIONAL INFORMATION
•
•
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
t State Forth 5673 (R51 10-01)
rw 'Prescribed
by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We)
1 (We) occupied as our prin . al place of residence the following described real property for which a
❑ I (We) owned ❑ Are buying under contract
Have a beneficial interest in the entity that is liable for the property taxes on the property and th;
FORM YEAR
HC70
of March, 20
is hereby claimed:
a contract.
?CO_NTRAC_T:RECORDED;
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
'-
P, ROPER7Y DESCRIPTIONf '':. "'"k'' --`'` ,$ars`•"U7`.
Cou
Toomship
County Township
district (d , , wnship) -
amber
Leg d
o
(Taxing
// ?_
� mReal
V70 7
property ❑ Mobae Hone(LC.6r.1 -7).
If any portion of the residentlal structure or the land not exceeding one (1) acre that immediately surrounds that s cture is used to produce income, describe the use and portion
of the property utilized to produce income.
d
7
PR6P. ERTY / OWNE6: 13YeC1A1MANT- I4;0TNER`COUNTIES;,:ovr
County
Township
County Township
I hereby certify the above statements are true, correct and complete.
�igpdJure rf Iaunant
umbQ{aM street.
'� ate. z COdeI OGIIL.J r.(Y�t� td'tj /A/� / 7�f/6V
TRUETAX
jASSESSED VALUE
HOMESTEAD
NONRESIDENTIAL
VALUE H
AT.;100°b'OFTMTIVy`-
VALUE
'Y,tVALUEj?'
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
rk' - __
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
1`y 'rr"'
r2`Y3
Residential improvements
. -.-.,,
�-
Garage
(5)
W-w_
Other improvements
(6)
y '
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verilying action - Signature of Auditor
Date signed