Homestead_Hudson (3)Prescribed By State Board at Tax Contm¢sioneis
CLAIM.FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR.lgg2
— / SEE BACK FOR FILING INSTRUCTIONS
iWe) � V 7' .
ch, 1941-11�- I, ( e) occupied as
which a Homestead Property Tax Cre(
I (1Ne) vowned
❑ are buying under contract
❑ have a beneficial interest in
Property Description in
certify that on the 1st day of
Jr principal place of residence the following describe real property for
lit-is hereby being claimed:
the taxpayer
County Township
Taxing District (City, Town, .Township):
Parcel Number
or legal description shown on tax statement:
X37-7
If buyin ; ors name tee simple owner)
tr U)
gqA�Cgqontract recorded in Recorders Office - Record No. Page
If any portidlW l e r�5'igntial 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
Any other counties in which individual owns or is buying real property: County Township
y certify the above statement is true, correct and complete.
Street Address
and zip code
Individual either owns or is buying under 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 -
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other Land
Total Land
Residential Improvements
True Cash Assessed
Value Valuation
(1)
(2)
(3)
Dwelling (4)
Garage (5)
Total (6)
Ot�lmprovements
Total Improvements - Line (6) plus (7) equals (8)
1 hereby certify the above is true. correct, and complete.
S'gnmure of Assessor
(7)
(8)
ACTION BY AUDITOR__:
Dan-
Homestead
Valuation
STATE FORM MO(10/&It) TREASUPES FORM IS-IA
• APPROVED BY STATE BOARD OF ACCOUNTS.SW PRESCRIBED BY THE DEPARTMENT OF LOCAL GOYFA\M ENT FLNAVL4 IC 6-1122-R1
• Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
tY\ 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 information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
L Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
.Itt APR 8 2011 Taxpayer Name Location Address
711 Hudson, Terry A/Cathy Ann
197 W 550 N
GIBSON COUNTY AUDITOR I III IbI
ill ll�DIII I II IID II P ATOKA I N 47666
769 •
111111 DII III I I II/1 11 m1111111 11I1I II III II Terry-A/Cathy Ann Hudson
197 W 550 N
Patoka IN 47666-9073
1II'11111111111i"111'III'1il'I1"11111"111111111'lili11111'I'ii State Parcel Number Legal Description
26-05-18-100-000.434-018/ PT NW 16-1-10.377 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.
r • _____ - ____ _ PART 2_TAX AVER INFORMATION
OM,.er I First A I 11\ Middle d s^ last
e2 r r
Social Security Number(last 5 digits) Driver's LieenseiState ID Number (last 5 digits) Other(please specify in Part 4 below)
1111214- 14 12-151 1 Ail slate
Spo First Middle Last
Ca-Ph n meson
Mailing Address(Num and street,city,state,and ZIP code) CJ1 m
Sae as property address
( IN e �D J Rojo-ea, rki 4-7CoCp 1�l
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 Si at Date /
