Homestead_Bean (2) •
STATE FORM!OAR ile/ATM TREASURER FORM 7S-IA
.APPROVED BY STATE BEIMADOF MTTWL.T5.1.n PLESOUBFDBY ME DEYAR1kNror LOCAL GOVERNMENT FINANCE IC RI.1-r-S.l
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
e 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 e'er for homestead fraud.Homestead fraud causes higher tat bills for all;therefore,
HEA 1344-2009 requires mapa■ers who receive the homestead standard deduction to verify that they are elieide to recene the
benefit and to provide additional identifying infomTmlon necestry to allow county government to better monitor homestead
filings.This information will be kept confidential and can only he accessed by authorized county officials.The Department of
Local Goverrunent Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
—. Bean, Wendell J Sr/ Debbie Ann
4837 S 875 E
Oakland City IN 47660
3230
Wendell J/Debbie Ann Bean Sr Sr.
4837 S 875E State Parcel Number Legal Description
Oakland City IN 47660-8529
I tlullntItIlntll.tllntluln1.1 .s1.li,i..nlltl,.tlnllrl 26-20-03-100-000.394-001 001-00394-00 PT NW 3-3-92.226 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
Ow,,ne''r//I / First Middle y� (� Last
—IN.t—n el z/' \.) U C— 13 ton J�
elAddress(number and street,city,state,and ZIP code) Es Same as property address
L1k.37s 4,5 0411%„�.I C ,'1yy -1- n Y'7//u
)
S First Middle Last
Mailing;Address(Number and street.city.state,and ZIP code)
El Same as property address
433r6 K 95 E ,t� r ei (I t I l T Ll7 o(0n
- - _ — ------
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
PART 4:ADDITIONAL INFORMATION
•
T- buv no on contract: p,;ners nalre (fee silrs,le o-.•.-ner
Contract recorded in Peco_dar's Office - P�ecord Pb. Page
if a;),v cortion of the residential structure or the land, not e.z:e-aiing one (1) acre that
Lm- e,_Lately surroui ds that structure is used to produce i -none, describe the use aid LYJrt1011 Oi
tine prop rty. utilized to produce income
Pn.l, other counties in which, individual oo-ns or is buying real property: County 'Itr:.nsliio
}l_.reh�' C°Si1iy. the above statorent 1s true, correct and corplete.
na =e Street P,��ress City, state and Zip Cku.:
"Individi.al either c.,-ns or is buyijig uner a contract that provides he is to pal the
grope,ty taxes on the residence, or has a beneficial interest in the taxpayer. I
- FOR ASSESSOR S USE ONLY -
L,,arj not eveeer_ing 1 (one) acre illaTe .ately
surrounding residential inprov-Enents
Other L_nd
Total Land FILED, Pos;dential lnprov
D1elLing
OCT 4198(1 Garaae
Total
0
s
(1)
(2)
(3)
(4) .
(5)
(6)
True Cash Pzsessed Imes
Value Valuation. Valua
AUDITOR (7 )
CtYler Iirorovanents —
1C Itic>rovelLnts - Line (6) plus (7) equals (8) (8) _
1 '�reb � y cer fy the above is true, correct, and comaleta.
Si nature o Assessor
- ACTION BY GUDITnR -
Date
MIN
Date
V _H IN
WI W'i rUt( IIU'tJILHU
MUI'Lltl I Ilan U1cuII Ill I Lit \ .L:)
5[E BACK
OR FILING INS
0111S /
& certify that on the 1st
day c
P'=ch,
19 1, We) occupia3 as o rincioal place of residenc- the folladnq described
real
nroperty
for which a IkmestA.a Prop y
Tax Credit is hereby 1 Ring claiifed:
nFSi
po I = o
are buying under contract
.070'0 3 -/00_000.39 -aal
Q have a iy�efici > es in
the taxpayer
pros °_rty
Description In
County 1tii�a
lG }li
Ta>•ing
District (City, Tch:n, 'Ibwaisliip):
Parcel
Himbar
or legal description s}rnm on tax ;tatomst:
I I
Or
T- buv no on contract: p,;ners nalre (fee silrs,le o-.•.-ner
Contract recorded in Peco_dar's Office - P�ecord Pb. Page
if a;),v cortion of the residential structure or the land, not e.z:e-aiing one (1) acre that
Lm- e,_Lately surroui ds that structure is used to produce i -none, describe the use aid LYJrt1011 Oi
tine prop rty. utilized to produce income
Pn.l, other counties in which, individual oo-ns or is buying real property: County 'Itr:.nsliio
}l_.reh�' C°Si1iy. the above statorent 1s true, correct and corplete.
na =e Street P,��ress City, state and Zip Cku.:
"Individi.al either c.,-ns or is buyijig uner a contract that provides he is to pal the
grope,ty taxes on the residence, or has a beneficial interest in the taxpayer. I
- FOR ASSESSOR S USE ONLY -
L,,arj not eveeer_ing 1 (one) acre illaTe .ately
surrounding residential inprov-Enents
Other L_nd
Total Land FILED, Pos;dential lnprov
D1elLing
OCT 4198(1 Garaae
Total
0
s
(1)
(2)
(3)
(4) .
(5)
(6)
True Cash Pzsessed Imes
Value Valuation. Valua
AUDITOR (7 )
CtYler Iirorovanents —
1C Itic>rovelLnts - Line (6) plus (7) equals (8) (8) _
1 '�reb � y cer fy the above is true, correct, and comaleta.
Si nature o Assessor
- ACTION BY GUDITnR -
Date
MIN
Date
V _H IN