Homestead_Bent (6) SINE FORMOY'iR!+dr T F:SURER PORN 7.3-IA
AP/ROVED By SPATE BOARD Or Aft\R.\Ti,_n• PRESWBW BT TIE DEPMNRYr OF LOCAL COVER,YMPAT FINANCE n-ilrat
Main ain Auditor
101 IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
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 e'er for homestead fraud.Homestead fraud causes higher tat bills for all;therefore.
® HEA 1344-2009 requires tatpasers who receise the homestead standard deduction to verify that they am eligible to reecho the
benefit and to provide additional identifying informmwn necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only to accessed by authorized county officials.The Ikpartnrnt 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
Bent, Gregory G/Jacqueline A
902 I:Walnut
Fort Branch IN 47648
7780
Gregory G/Jacqueline A Bent
902 E Walnut State Parcel Number Legal Description
Fort Branch IN 47648-1242
1111111
26-19-18-304-000.065-026 011-00065-00 HOLCOMB ADD 92PT/93
t o neIt II toI n I I uI nu I I nIeIt I ll I I t I I I I
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
arl°lorV aeor3e �G✓l� _ _ _
aline Address(rt mber and street,city,state,and ZIP code) ® Same as property address
90? E, Walnut Fort erun,ti ci 7Grt7
Spouse First Middle Last
3."-C)C1)0e.- e- nn
Cent
Mailing Address(Number and street.thy,state,and ZIP code) ❑ Same as property address
qoa E. wglno /,t enrich hi v74-4 't
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjuy,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 1 Signature Date
•
FOflM HL 10 1979
PreuriUeO By Slale BwrE ol Tae Cammissioners
n ..
CLAIM FOR HOMESTEAD PROPERTY TAX CAEDIT FOR YEAR 19 B�
To & FileO in WDliwte
SEE BACK FOR FILING INSTRUCTIONS
�(We) ��`""�� �^ �- � �• certify that on the 1st day of
rAarch, 19�1., I, (We) o�as o r principal pl ce of sidence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned D// �QQl��Q�
❑ are buying under contract
❑ have a beneficial interest� in the taxpayer
Property Description in b^-"�-�^ County �� Township
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name �'� $tnp1e Oxne`�
or legal description shown on tax statement:
�L,_2- C�.�2 9y P.�. ,�- 9 3
Contract recorded in Recorders Office - Record No. Page
If 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
Any other counties in which individual owns or is buying real property: County Township
� hereby certify the above statement is true, correct and complete.
' 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 -
�I�� i 1) True Cash
'�'d Value
Land not exceeding jyJ�e� �cr�t� mediately
surrounding res]dential imp oGemeYits (�) 9�
Jt
Assessed
Valuation
.1 o--a
Other Land , �, (2) — —
Total Land AUDITOR (3) _�e-v .�cy
Residential Improvements Dwelling (4� `��
Garage (5) °��-'�O
Total (6) �L� G o -<- a�-r.
Other Improvements (�) —
�T '�� improvements - Line (6) plus (7) equals (8) (8) -�-�� �"'
eby certify the above is true. correct. and complete.
�i.. �. � 5t. . ,. _ ,� , ` 3 -�- 8i
Sqna:ure of nssessor
- ACTION BY AUDITOR -
Oa�e
Homestead
Valuation
�,
�� •
Date: ,���'3 - �