Homestead_Nonte CLAIM FOR Hft'ESTEAD PROPERTY TAX CREDIT FOR YEAR L_
SEE BACK FOR FILING INSTRUCTIONS
•I ) L.,Ler, , `/ b-re e._e . 12. certify that on the 1st day cf
mas 19 , I, (tWe1 occupied as our ptincin I piafie of residence the following described real
nroc zv for which a Homestead Proodrty Tax Credit is hereby being claimed:
I, 0%e) ❑ cwnei
pare buying under contract
❑ have a beneficial interest in the taxpayer. . . I
Property Description in . _ /. _ (5-yv County l) 6e Township
Taxing District (City, Town, Township) : /L) 5.
Parcel Number
1 or legal description shown on tax statement:
(2 -i � 5-/- // /. p3y
If buy_ing on contract: Owners name (fee simile owner)
Contract re2orded in Recorder's Office - Record No. Page
If any portion of the residential structure or the land, not ewe&;*g* one (1) acre that
immediately surrounds that structure is used to produce incase, describe the use and portion of
the property utilized to produce income
Any other counties in which individual owns or is buying real property: County . Tvanshio
I :®by certify the above statatent is true, correct and complete. •
C_t r >y 4. n7 / .4,19z. /&-S . '-10A' 4a 4ig &nJ 6 7 2'G,/.
65wiature . ' Street Address -. City, State and zip Code
*Individual either vans or is buying uner a contract that provides he is to pay the
property taxes on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
. True Cash Assessed Homestead
Value Valuation . Valuation
Land not exceeding 1 (one) acre immediately
surrounding residential imorovements 5-00 5-00 / 7 0 o
/�� 0
Other Land (2)(3) so 0 / 70 %/ ///,
Total Land //// /////
Residential Improvements Dwelling (4) a 7 Cc 3 ° 1/��/- /1 O�/////���/�/�Fl
•
_ Garage (5) "iiIill/ ////GG! /4
Total (6) a7a, -3o 9a /0 ///?2-,0
Other Improvements (7) ///////�/ //%
To. .) Inwrovarents - Line (6) plus (7) equals (8) (8) alt' 3-o 9a'/O ////////%///A
I r-eby certify the above is true, correct, and complete.
?;o f e 7—
Sigru z of Assessor Date
ACTION BY AUDITOR -
a*,n,rn,cA, Date: f
I
• STATE FORM!Mt.tIU rMPO TRFASURER FORM IS-IA
.APPROVED BY CIATE onnaorn API PUNIC,20(.1 PREXRIBWDBYnIE n!'PARh@vtOFLOCAL GWERVMETT FINANCE M61,1-5}R1
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 eser for homestead fraud.homestead fraud causes higher tae bills for all:therefore.
HEA 1344--2009 requires taxpayers who receive the homestead standard deduction to eerily that they are eligible to receive the
benefit and to provide additional identifyine information necessary to allow county goemnrent to better monitor homestead
filings.This information will he kepi conhcential and can only he accessed by authorized county officials.The Department of
Local Goeermnent Finance will use this information to create nails that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Prnperh'Address
Nonte, Timothy J/Joyce A
RI Box 10-b,r1LI
Patoka IN 47666
647
Timothy J/Joyce A Nonte
622 S Old Patoka RD State Parcel Number Legal Description
Patoka IN 47666-9002
r�r�rr��rtr�� 26-04-25-400-000.560-020 018-00560-00 PT SE 257111.0036 AC
rrtrr IiIiuIiIiiIiIrllrrl
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
17127 J-4 M7 es A/O/vTE
mg Address(number and streci;city,state and ZiP code)_. —._ - - Same as property addrms__ — - — - •
622 3. 0/D PATOKA .2D.
1,117- k'A, Tit/ t'76 6- 900,2
Spouse - First Middle Last
J OWE ANN ,APO/V%F
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
62.2 .5. 6/0 f>/3-TOax,4 ,20•
R,4TOK,q . _z.+/. 'f7 Gt - 9ooz
.
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 Signature Date
'1 PART 4: ADDITIONAL INFORMATION