Homestead_Fraker STATE FORM Meg(• 15-to) .,
' APPROVED BY STATE MAIM 01 COUNTS YW PRESCRIBED BY THE DEPARTMENT OF LOCAL COY
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERT-I . _ ia-
101 N. Main Street. Individuals and married couples are limited to one homestead standard.deduction.As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive dun ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
Alibenefit and to provide additional identifying information nttessarv,to allow county gmemment to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
FILED PART I: PROPERTY INFOILNIATION
Taxpayer Name Location Address
�/ - Fraker, Gary Al Patricia L
• MA 5y'--'-g(\-[2011 904 MOHAVJK DR
C.�.nI1 FT BRANCH IN 47648
7760 uu I
904 Mohawk[ Dr LAUDITOR " ii IIIII_ lip 1 IIII III ID DIII fllIII II imii-III mill II�III i_mmmiII IfllI- II
Fort Branch IN 47648-9508 '
1111111t111ir1111111t 11111111111111tt11111t1t1t1ts11t1t111tt1111 State Parcel Number Legal Description -
26-19-18-101-001.005-026/LITTLE YORK VILLAGE 16I19PT
PHASE 1
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.
Ir ______._._-_,____._ PART 2:TAXPAYER 1FORMAI_ION___
Ow_ 1 First Middle Last'
Gary - 4. - Frat.ker
Mailing Address(number and street.city,state,and ZIP code) . ® Same as property address
Foy ifl 4at,,k 1)r. For+ Brahr_iv IrJ "17(41£'
Spouse DD First Middle . Last L to}i ?eiQ I-raicer .
Mailing Address(Number and street.city,state,and ZIP code)' ®Same as property address
goy Moil4wk Dr. Fort Bvarsck =� 117GYg
• • 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
unlawfully,he or she may be liable for back taxes and substantial financial penalties. '
Owner I Signature Date
,���"` ���" - CLAIM FOR HOMESTEAD PROPERTY TAX
'�° CREDIT/STANDARD DEDUCTION
r State Fortn 54731R2 / 5'92)
INSTRUCTIONS: See ieverse side (orliling instructions.
STATEMENT
FORM
HC10
YEAR
I(We) certify that orfThe 1 sf�a¢b�MFa�Tr, �19m
I(We) oc ie as our i ipal place of residence the following described real property for which a Homestead Property Tax Credit is Cherefbfy(1cf1laimed:
❑ I(We) owned ❑ Are buying under contract . AUG L v �JJJ
❑ Have a beneficial interest in the eniiry that is liable for the property taues on the property and that owns ihe properry,or is buying urder�contracJ,
It buying on conVacl, Fee Simple ownets name
RecorAer's office wtiere cantmct is recorded
Tawnship
Par�el nur�bpr� /O� �� Legal tle
O ( �
II any ponion o( Ne residential sWCture or Ne land not
the property uUlized ro protluce incame.
CONTRACTRECORDED.
PROPERTY DESCRIPTION
PROPERTY OWNED BY CLAIMANT IN OTHER
certity the above statements are true, correct and complete.
ASSESSOR USE ONLY
Land not exceeding 7(one) acre immediatety
surrounding residential improvemenis.
Otherland
Total land (line 7 plus line 2)
Dwelling
Residential improvements
Garage
Other improvemenis
Total improvements (line 4 through line 6)
Total value (line 3 plus line 7)
I hereby certify ihe above is true, correct, and
complete.
19_ Pay 19 _
Lesser of 1/2 Homestead
yaluation or 52,000
(�)
(2)
(3)
i41
(5)
(6)
P)
(8)
TRUE TAX
VALUE
of Assesor
ASSESSED
VALUE
STANDARD DEDUCTION ALLOWANCE
E�
to
HOMESTEAD
VALUE
use
Township
NON-RESIDENTIAL
VALUE
,a6 �,