HomeMy WebLinkAboutHomestead_PennerCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State ForrnS,173 (R5110 -01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
I (we) L -) certify that ErM 4tQa=rch. 20_
1 (We) occupied as our principal place of residence the following described real property for which a Homes roperty Tax Cr
hereby claim
❑ I (We) owned ❑ Are buying under contract te ,Lpe�y.Tax, edli ised:
-lave a beneficial interest in the entity that is liable for the property taxes on the property and that owns Te(3K30"ogLk1buyiqgtq ei�o t"
Mprfejfo tract.
ig4w@gNM5!!��4!����5���-.C-ONTRACT'RECORDED'sT
-�- . " 7
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
P -EkT:y 16N
-7 R 0 R
0. bur
Coun
Township
Tmin istrict (city, I , township)
1 hereby certify the above statements are true, correct and complete.
45 4 dyU
Address I
ATY100% OF TNT
ag 7rr7"7;*7)1//y /m
Legal d I.
Is the property irVstion
surrounding residential improvements.
❑ a,, property
Mobile Home (/.C. 61.1-7)
I7 any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to producia
income, describe the use and portion
of the property utilized to produce income.
i<R
00,3- 0C2-a5'0 - 00
Total land (fine I plus line 2)
(3)
K�c, PFfoPhkty.bMECFBY dCAIM-ANt.ii4bTHER*d6Lfktiitt�"i�-.'�. :-Id}:*-,'�{�z;,1�� r_,,, �
County
Township
County A Township
1 hereby certify the above statements are true, correct and complete.
Sign ture imam
Address I
ATY100% OF TNT
ag 7rr7"7;*7)1//y /m
,
-Tr
;ESSOR, USE ONLYZI�f �tL :�Qt
��MTRUETAX"
RIK
�4SSEgsiff�Wk
t�;3HOMESTEAD,�
NONAESIDENTIAL-N,��'--
'�VALUE--J-
VALUE.,
ATY100% OF TNT
WALUEM.1
Land not exceeding 1 (one) ache immediately
surrounding residential improvements.
Other land
(2)
i<R
Total land (fine I plus line 2)
(3)
M'h
Dwelling
(4)
Residential improvements
Garage
(5)
. . . . . . . .
. - - - - - -
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 phis line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20_
Lesser of 112 Homestead
Valuation or $6,000
Signature of Audftw
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SIAM FORM!)vwsR_/!wl MAMMA FORA 173-IA
APPROVED BY,t ATE BOARD CIF"(COUNTS.:On PEERA®m BY TIn DEPARTMENT(if LOCAL GOVERNMENT FINANCE MVI.1 r4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sundani deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying informatun necessary to allow county government to better monitor homestead
filings.This information will be Ulu confidential and can only he accessed by authorized county officials.The Depanntent of
Local Government Finance will we this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Penner, Bill/Vergie Life Est
HI
Griffin IN 476A� 1�
2145 LQ/C1),l,D
Bill Penner 1
R1
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GRIFFIN IN 47616 State Parcel Number Legal Description
26-16-20-200-002.250-023 008-02250-00 PT NE 20 3 13 1.00 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 1 First Middle Last
/3/Lzip 506 Nr' th/NER
song Address(mum and street,city,state,and ZIP code) Same ns proper address
'7 s /475 v✓ 6.5311--P14 iN 478/6
&'
Spouse . Middle Last
//3GiE S49J'ON PEAIN5
Mailing Address(Number and street.city,state,and ZIP code) 1"S:une as property address
6878s /6751st 6
CsRl��ii✓ /.(l � el
-
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 ' nature Date
PART 4:ADDITIONAL INFORMATION
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