Homestead_Butler •
STATE FORM!3••IM1:flat TRFASURIR PORN SIA
.PPRtwED BY Stilt IRNMat ACCOUNT:C.:ON Prr.YNBm BY fir DFPMTNE•TOF LOCAL cmvasMrnT FEANt'E tc 1i- -it
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 lax bills for all:therefore.
40 ILEA 134;-2009 requires taxpayers who receive the homestead standard deduction to verify that they are elieihle to receive the
benefit and to provide additional identifying information necessary to allow county eovemtnent to better monitor homestead
filings.This information will he kept confidential and can only be accessed by authorized county official.The Ilepanment of
Local Government Finance will we this information to create tools that will help county of vials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Butler, Emil A Jr/Carrie
7876 S 45
Fon Branch IN 47648
3026
Emil A Butler Jr
7876 S 45 E State Parcel Number Leaal Description
FORT BRANCH IN 47648-8014
26-19-19-204-001.304-026 007-00111-00 INDIAN HILLS 66
I n II toIt II nr I n II u I t I u It II IIt I o II tat IP II o IP It I D-27
_ _ —>CS
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.
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
Amy \ A u'M fir,
¢Address(number and street.city,state,and ZIP code) $ me as property address
f 1 7)1 E
Spouse First Middle rip Last
Mailing Address(Number and street,city,state,and"LIP code) Same as property address
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.
Own .ignaturc Dat^
•
CLAIM FOR HOMESTEAD PROPERTY TAX FORM 1'EAR
CREDIT/STANDARD DEDUCTION Hc�o
smee F«m u�a �c i �-asl
ResaiEeE by Me DepaMient d Loral Gmromnbnt Finaxe
INSTRUCTIONS: See iewrae ddo b f8hp iKbuctionr.
�?'=��,r�-��'°=�.�.r,�;,.,.x''.§,°�».,"�s'',"'-n:s,'. �'��;�v�3ut��CERT7FICATION�STA7EMENTFr+i�rs.�",. , d`i�' .�- �'-}?� t_ �;.
. s�+r -r °;k.-ti �.,g�'� . _ -�.�'�'iii� .
_ .__."_ .____"_ .._.__ 1 �>-+w=
I n^Ie� , .
"' certify that od�`�sllday o�lA��. 20_ .
I(We) occupied as our principa piace residence Ihe following described real property for which a Homestead Propert'-y-�yTa�c Credit is yhereby daimed:
❑ I(We) owned ❑ Are buying under contracl p'/a�. �/�
C/ C/
� Have a benefidal interest in ihe en6ty that is liable (or ihe property taxes on the property and that owns the p�{$g�01 i56cyjNi'§`Gntl�%QRraU.
If byvg on conVacl, Fea Simple owners name
Recorders afice where mntracl is recorEed
Caunty
Tuvnship
P numyy �' / f- D� I Lagal e ' lo
/�
I( any poAion of Ne residmUal strucfure w the lantl no� exceeding
of fhe property u6Tized tn produce inwme.
disUict (cily, Iown, township)
Is the properry in queslion:
❑ Real Droq
Rewrd number
❑ Mo�ile HomO
Page
67.
that immediatcy wrrounds that sWCiure is used b produce income, tlesaibe the uu and ponion
A"'�" � '°�"�'-"''�`��'�9 �"y�i -�- sTRUETAX , s� �ASSESSED���VACUE �HOMESTEA� '� .�,{`NON-RES�OENTIAL �ri
;�.�� .� AS5ES�SO�R�US.�E,O�NLY � � .�VALIlE7 � "=ATM700%'OF�TfV� ��`._-�.'�-,VALUE �: ,.a ��,`�..�.��:wVALUE�a�,� ��
�� ��€� --5]?`������ � �� G � � � �
Land not exceeding 1(one) acre immediatety �'�`�, ���'�'� ��`-;�.�`,. �, �` e;
surtounding residentlal improvements. ��� �.<3 �, �y'� a.-+ ��
;... "�" �e'�.'�' �`F;:.�.�.
Other land �2) �` v�%�i �t� �
�
���.��
Tdal land (line 1 plus line 2) (3)
°.�s v'i y{3Sf�+ -'Lhe�g�,t�fi3f?}�` f'-„'�: - .
Dwelling (4) s� i^F � ��1 � �.
�ResidentiellmprovemenisorMnuaOy ��F��'�.,,r.ss."�-�..a�"�3 � .
Asse�ed Mo68e / Manufadured Hame Garage (5) ����.��� �" �,'�
�+s:..�� ,�.:.�. _.'
�•. .: r.— �,
Other improvements (6) ;��K��y�'�
�t,n �-��
To1al improvements (line 4 through line 6) ���
Tdal value (Gne 3 phs line n �g�
I hereby certify fhe above is We, corred, and Sgnature of Assessor Date signed
completa.
Vr1i(ying action - SignaWre of Auditor Date sgned
'�s��.�'�c°y�`^��S:.Y��;�'k?`ar.`�a���'y?, y�,���STANUARU!UEDUCTION'ALLOWANCE:":�'��'�. '^^"^ `�
�.�^�.e�1n.:a.+l.��Y-'2?d3��'`��:`t`�.s�� a
20_Pay20_
Lesserof 1/2 Homestead
VelueUOn a 535.000 g
Sgnature of Auditw " Date signetl