Homestead_Foster I {LATE FORM!Pt.IR:1 Se i TRY-WALE HAM 73-IA
APPROVED BY SLATE BOARD Of Tice usTS,`ow PRISCRIBED BY list DrrARneT(w LOtAL COVERNMrNT Ft.SCE Ie♦I.I-r-a.l
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
�l 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 ever for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
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.'Ibis information will be Lept confidential and can only he accessed by authorized county officials_The Depannieni 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
Foster, Corey J/Melissa R
40211 Mulberry
Fort Branch IN 47648 `I
2930
Corey J Foster
402E Mullberry State Parcel Number Legal Description
FORT BRANCH IN 47648-1636
IIlttllttrltlltttittllttlttrrllrllrrrrllrrli.rllrrtrtirlrrlltl 26-19-19-101-000.714-026 011-00714-00 PT NW 19310.3224 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.
N.
_ PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Cora] Son roster
g Add (number and street,city,state,and ZIP code) Dil Some as property address
ttoa E /Mulberry 51'reef' fi. Branc.A. l u769g
Spouse • First Middle Last
Melissa Recut rocky-
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
4oa E AA u Ibern, SI' P+. branch. m1 474,1 i'
PART 3:CERTIFICATION. . .
Each undersigmed 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 •• liable for back taxes and substantial financial penalties.
Owner I 'gmature _ 1 ,Date
IP
R, CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
/ StaleF«mS773(R6/403�
Prescnbed by lhe Department ol Local Govemment Finance
INSTRUCTIONS: See reverse side lor /iling ins(iuclions.
` i� �••F' �' ''.�
� ;�
NOV 0 8 2004
� M�e) / certi KaCO�H Aa
I(We) ' as our cipat place of residence lhe following described real property for which a Homestea P�3�r�aFQi� i is here y daimed
I(We) owned ❑ Are buying under contract
� Have a benefidal interest in the entity that is liable for the property taxes on Ne property and that mms the property or is buying under a wnVaU.
I( buying on conUaq, Fee Simple ov:ners name
RemNefs ofice whera coniracl is remrded
County
Tamship
) � �� �% "C� �..� �, ���1,� ��' � /0 -
ot Ue resi0ential sWdure w the Wnd not e:ceeding one (1) aae that imm[tl
y utilizeA b produce inmme. '
To.vnship
I hereby certify ihe a6ove statements are W e, corted and complete.
�iress �number and sfreef, cd}; sta(e, ZIP code) _ .
Land not exceeding 1(one) acre immedialely
surrounding residenGal improvements.
Other land
Tofal land (line 1 plus line 2)
Dwelling
Residentiel improvements or Mnualty
0.ssened Modle / Manu(aclured Haire Garage
Oiher improvements
TUaI improvemenLs (line 4 through Irne 6)
Tdal value (line 3 plus line n
I hereby ceRi(y Ne above is We, coned, and
complele.
VeJifying aclion - Signature oflwditor
i+)
(Z)
(3)
(4)
(5)
(6)
1�)
(8)
Signature ofAssessor
Record number � Page
��/1 � t1 J��Q �V�/�A `i
Ne property in question:
❑ Real property ❑ A7obile Homo (I.C. 67.7-n
Kat swdure is used to D�uce income, describe Ne use antl ponian
signed
signed