Homestead_Burns ~
SAIL FORM!Kt. l/,+nl 1PF.15UIIX FORM:}IA
ArrROVEO ov STATE OMRO OF MrTU]TS.y0/ PEr11LInm BY THE OFPARTMEn OF LOCAL CA\4RYMrn FINANCE IC 6-1.1-2:-CI
Gibson County Auditor
101 N Main u IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As die receipt of this deduction become,
more beneficial.there is more incentive than ocr for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
el 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 nformatwn necessary to allow county gmemment to better monitor homrsleal
filings.This information will he kept confidential and can only he accessed by authorized enunly officials.The Ikpannrm of
Local Government Finance ss ill use this information to create tools that will help county officials eliminate homestead fraud.
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PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
—. Bums, Carolyn S YC"
.W-Virg+nia- l 11"�
-b
-I:rmuv'xr4a:17711 Rccc1i eSS
7003 I O.7 6. C1/4 1C *.
Feast B+aRxet.t k/
107 Carolyn
Oak S Bums -1 „p7 y y-7 0y 6
107 Oak State Parcel Number -"'"Lethal Description
FORT BRANCH IN 47648
26-18-24-202-000.166-026 011-00166-00 MCCRARY ETAL 97
X
PART 2:TAXPAYER INFORMATION .
Owner I First C Middle Last
C-e. (C)11.0 So 13uY `1 .<,
•ng Address(number and street city,state,and ZIP code) - ❑t Semc as pTOpeny addre—li-- - - - — ._ --
101 IS . aK t . tR c-61. 1•1c \n
Spouse First Middle Last
Mailing Address(Number and street,city.state,and'LIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
Star
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
unlaufillly,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date
)
_ .
;� CLAIM FOR HOMESTEAD PROPERTY `TAX., -.r ,-�� FoRM YEAR
CREDIT/STANDARD DEDUCTION ' p
t I . Slatc Ponn 5473 (R6 / d-03) .• . �
Presuihetl by Ltie Department o� loca(Governm�ni Finandr'•• �� - � .
INSTRUCTlONS: See �everse side !or /iliny ir,sGuclinm:' ' : � � � � � � ,
- i .
� " . "` ji "'-` "�. � -: � .�-� '::CERTIFICATION STATEMENT; �;,'i*.� �' '. -" �
€-� ._ r. �v�t. � __ T .� 3P, = z. _ t *�. :. .-. . .. ..e. . . '
I (We) cA X u�.� ��1, � � � ��i e ,�.�J.. � . ' . . • certiry that o st�:�l��arch. 20
I(We) occupied as our principafplace of residence Ihe ( owing described real property (or which a Homestead Property T redit�reby daimed:
�I (We) owned . ❑ Are buying under wnlract ' � •
GIBSON COUNTY AUDITOR
iHave a benefidal interest in the entity that is liable (or the property taxes on the property and that owns the property or is buying under a wnVact.
�s,�;.�--C'�'�a�?Fr '�rs4��:�.'�..c.,x'- t ,.a`_��� �'�. �..7�:CONTRACTRECORDED*_?i; � , _�.�. �. - •.: - �== -
I( buying om m�tract, Fee Simple owneYS name . .
Recorde�s otfica where comract is recorded - , . _ Record number Page
Couniy � Tavnship Tacing disl �tt �tify, fown, fownship)
Parcel 1ny�I+�ber - Legal descnption Is the prope question:
� ` l ^ �b, �_ _ 1 I �teal pmperty ❑ Mobile Homo (I.C. 6f.7-7)
It any portion of the resi�enllal slrucWm or the lana not eaceeding ona (7) acre t�at immediately surrounds Nat sW ure is used b produce income, descnbe Ne use antl portion
ot Ine properq utitized t� produce incame. �
Counry
Tavnship
0
I hereby certify the above statements are We, cor[ect and cbmptete.
'dress (numberandstrcet, tiry, stafe, ZlPcode)
_� �(r� �. OaK �t. �f. r�hcJ� .
)' .'1. �
� ; "'
3 I.
�* �'H''�' i� 1'-'FSr y^'''..".'tt�"F -z "i. �' '`i`'j''i'' w . . . � '' NON�2ESIDENTIAL
x���� �ASSESSDR �SE ONLY F���r�� � f tTRUETAX.� �� � ASSESSED VALUE ��HOMESTEAD�y syU� �` '
����Y Y.S�'Y`.3: :,^_X�_ �'? .: L..�_�� � �.�4 VALUE�t � � �AT 700%OF�TTV� �`�„�VALUE� � �,-�? �_��,,t.,'�.VALUE . y �c.�-FF
ILand not exceeding 1(one) acrz immediately �� n�-,�`E�,`�54-,�'"- ��'�Y�� �'"' z,�;k '�?
surroundingresidentialimprovements. . ��) ��°"`�-`.`k ``"`�3��-
...�c` �"n. t'} ,.� t-'
ONer land �� ���'r �i" �
. �p) j -..,,=,,�
� , ..E.�PlY�
Taai iana p;ne v Prus �ine z� �3�
� -,��- --� "
Dwelling (4) . t � 3�.' ,n'��Y ' �' si.� .-�
. . +- rl.t�-�a-''� � Y",tf_-� �. �
Residenlial improvements or Mnually .
Pssened Mobiie / Manutaaured Home Garage 5 �, �'�` �i yy,l �",�� r� ti�� _
( ) 'i4t:s.'�.c=�:x'�e•"4_�`i.�:{�,.z':�:i.;i-==.�
Other improvements � (6) ` - ��`�}` �
.=�� :
Tdal improvements Qine 4 through line 6) (�)
T[fa� value (line 3 plts line n (g�
1 hereby certify Ihe above is Vue, corred, and SignaNre of Assessor Da�e sgned
complete.
Vuifyiig acl"an - Signature olPuditor Date sgned
20 _ Pay 20 _
Lesser oi ti2 Homes;ead
va�uauon or 535.000
SignaWre ol fwtldor
S
signed