Homestead_Chambers lr\t£roR]IllwIRr(otAl T i Stilrt FORM:11A
Arr0.PtO ay STATE Doomoc 'ton •Lrflnn)DT fir DEP 1 iTOFLOCAL fin2CYMFKT ra:AsCE IC 41.10_'4)
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 mote incentive than ever for homestead fraud.Ilomesteal fraud causes higher tax bills for all:therefore.
• HEA 1341.2000 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to teethe the
benefit and to provide nddilional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorited county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY LNFORMATION
FILE C .6a Taxpaver Name Property Address
Ir*-rs, TroyA/Amanda M
100NMain
APR 7 LUIU Fon Branch IN 47645
2548 y,
Troy A Chambers a r
ctf
100 N Main St GIBSON COUNTY AUbltQrt
FORT BRANCH IN 47648-1302 State Parcel Number Legal Description
Itlttlltttltlltttltr��tt�rrtr��rrlltll I 1111...11...,1.1,1 26-18-13-404-000.611-026 /011-00611-00 OLD PLAN 36PT/37PT
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 Y First 47/94
Midle (1/U 5 Last
•rig Address(number and street,/ccittyy state,and ZIP code) /�/�Jm F me as property address / t
spouse ILL First /Ie��I1 Middle /,�, / Last
FhLgIL LG Mar fe /(J�kYLDe/S
Mailing Address(Number and street,city,state,and ZIP code) 1-1 U+m.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.
Owner I Signature Date
CLAIM FOR HOIIAESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
state Form u7a (RS �+m)
PresWbed by the OeDertmeirt d Local Govemmmrt Finance
MSTRUCTIONS: See iawaa alda Ibr IHrp irmbuctlw�e.
,
. �
1� : � % �L�;��(/l,
r
OCT 1 0 2006
I(We) V/ 4" l certiry that on the 1et,d�aX ��I�NTrv�A� G�L
I(We) occupied as o rincipal place of residence the following described real properry for which a Homestead Propert�7�?�f�dll T�Tereby �imed
�(VJe) owned ❑ Ne buying under conlract .
, Have a benefidal interest in Ihe enfiry that is liable for Me property taxes on Ihe property and that owns the properly or is buying under a conVaU.
If byvg on conVact, Fre Simple ownefs name
Recordefs of6ce where canVact is recorded
County
Toxnship
Parcei number Le I descn on
�l/-�o�ll-cr� .P�l � m 3 ,�-J
If any porliw� af Ne resi0entlal strudure w the lantl not exceeding one (7) • e Nat im�
W tha property util¢eE m produce irrcome.
`����� -i� i.� - S�s�c�. Gi/- oa�
County
I hereby ceAify the above statements are We, wrted and complete.
(number and sVeet, city, sfate,
Remrd number � Paga
Tating dis¢ict (city, fown,
Is the pmperty in quution:
�Jieal property ❑ Mobile Homo (I.C. 6f.1-�
w`rounds Nat sinicwra is used to produce inmme, describa Ne usa antl portbn
County
ol claimant
��4�`� �'�= ���"��} � � � � TRUE TAX='fi`�� �ASSESSED V/LL.UE `JFIOMESTEADr� t'�' eNON�RESIDENTIAL '�-�
xYs,'�'^' y ¢ASSESSOR�l1SE ONLY=�w�c �,e�, � x � � -+� e �5�-- �1� *�� +�s cs�?� s_, � +y��
� ,.�. " +�f 7frF�5!'� _T�'R•- �k:.�..� . wVAI:UE;r'�.�. � '. AT�100%.OP=r.TTVti .s. =.VALUE.. x'"s: .az3.�'�ALUE.Sw.� a
Land not exceeding 1(one) aae immediately ��`r`" t�`"*y--'..#i�`�, �',.�: �'�'ry�
surroundingresidentialimprovemenis. (�) �?>�'�';';'y,`�'�y`�n�,T-,���-_x�"�,.5�.�'y�p'
�y Y 4 c. `. -.z
Other land 2 ��'�'�'�' ' '' .
( ) .� �.r�,r'��3i<
Tdal land (line 1 plus line 2) (g)
y.�'" a` �s%.�ra�� yAp-,.�r=�
Dwelling (4) r? �i`'�r��y`�'�a.:, 't���u.�a
�Residentiel improvemenfs or MnuaOy �'4'"��'"� °"�":�'�'"i.'�'�`�'
Mxssed AAo68e / Manufac4ued Hanm Gara e �� � ��o� +;�t�nF- 'F
9 �5) �?i�L'�.'�i5r��'r-``'���a;,i.�
�����`�
Oiher improvements (6) �� ?i?-'4� s
`r . � ,� �e�c ,a�
Tdal improvements (fine 4 fhrough line 6) (7)
Taal value (line 3 phs line n (g�
I hereby certify ihe above is We, corred, and Signamre otnssessor oate signea
complete.
Vrlityirg adion - SignaWre of Pudiwr Date si9ned
`Yi "����,::r,j��:p���,M.?���.�STANDARU:OEUUCTION�AL'LOWANCE.��.'�?,a ����s-"��'+��_.��'�-."-�.,��:���
20_Pay20_
Lesser of 112 Homestead
vauauan a f35.000
5
SignaWraotAUdilw " Dates'gned