Homestead_Berry (3) •
StMME lt)RM9f IR:/vr.I - mrA9trn FORM 3IA
APPROCED BY Witt B■ RO OF Mnn*I.rS.!u`i • PRfl(AIBFD BY fir DEPMMEYr(w LOCAL rovtry M're%cEw L,-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 standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
•
HEA l$44-2009 requires taxpayers who receive the homestead standard deduction to roily that they am eligible to reeSe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only bc 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
Berry, Mark W/Stephanie t S
— 113 S Main - LG�
Patoka IN 47666 A f 1 elk i%
601 ''-7(ei 55
Mark W/Stephanie Berry a-
P O BOX 224 State Parcel Number Lezal Description
Patoka IN 47666-0224
26-04-25-102-000.348-020 018-00348-00 SMITHLAND ADD 2PT/3
1r1u11nr1r11ntlltnllnlluur1r1u1r1r1n1n1t1t1n11nt11
PART 2: TAXPAYER INFORMATION •
Owner I First Middle Last
Mk Qf\ K 11\1 Be r r y
�reAddfcsS(numocr and street.city,stem.and ZiPcodc) _. _ _- 0 Same asprcpcnyaddress- — ._- _
Po box oaf Pak-oka z_h) (4-1 ( b2(0
Spouse First Middle Last
S-Vapheni e. R .berry
Mailing Address(Number and street,city,state.and ZIP code) Same as property address
Pa as Pa-4 e_)kc<_ 110 q`(C.0(9
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 she may be liable for back taxes and substantial financial penalties.
Owner I Sign c Date
PART 4: ADDITIONAL INFORMATION
n
fi nil
eE a CLAIM FOR HOMESTEAD PROPERTY TAX F M R
CREDIT /STANDARD DEDUCTION HCJEP O 5 9]
.:, State Form 5473 ([1215 -92)
INSTRUCTIONS: See reverse side for tiling instructions.
r:FRTIFIr:AT1nM CTATFMFNT - ,RtDI� -�i 1??!)}jTt
I (We) _ 1_y �� _ _ certify that on the 1st day of March, 19
occupied as our pri 91 place . residence the following described real opertyfor which a Homestead Property Tax Credit is hereby claimed:
l(We)owned ❑ Are buying under contract
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying.under a contract.
- - CONTRACT RECORDED -
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County
Township
Taxing district (c it . town, township)
Parcel number
Legal description
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
0eby certify the above statements are true, correct and complete.
r
Signature of claimant --�
Address (number and street. ary stare. ZlP code)
I�"i 15. main Parka q-71elplo
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line 1 plus fine 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(b)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(S)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor Date signed
- STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
S
Signature of Auditor �..o.�t✓
Date " ned 5 q