Homestead_Graham •
SLATE I ARM''.a ILL Ia+nl IRIASULER FORM ILA
.APPR(A'EII BY ATATE BMROCW AC IA'NTS.25N PRISUUnm BY THE DEPARTMENT(W LOCAL CKT20.YNrKT FINANCE IC VI.I-L'J.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead aandard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than net for homestead fraud Homestead fraud causes higher tax bills for all:therefore.
• HEA 13442000 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to recene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only he accessed by authori,ed county officials.The Depanntent 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
Graham, Tony R/Anita J
500N Ilull
Fort Branch IN 47648
7675
Tony R Graham
500 N Hull State Parcel Number Legal Description
FORT BRANCH IN 47648-9793
I II III III III I III I I I I II III 26-19-18-302-000.120-02 011-00120-00 HILLCREST 52PT/91
t o fit t set u u r t n fir tun t to t
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
I bony (RAy C5'f aha rvx
Ong El(number and street.city,state,and ZIP code) El-Same as property address
500 Nor4- k u-uII SA- fork RrravcL LH(0 v8
Spouse 11 First Middle Last
A •
n t Y-A p fie 4 w.
Mailing Address(Number and street,city,state,and ZIP code) T[ .S me as property adders,
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 plate
PART 4:ADDITIONAL INFORMATION
I
�, CIAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form yi73 (R6 / 403j
Presrribed by Ne Department o1 Local Govemmem Finance
INSTRUCTIONS: See reverse side Ior Iiling inslmclfons.
`n�Q� FORM YEAR
�� �-9 .�T�HC10 ��' _"�I
i i
1L11.J1v�
. JUN 3 0 2004
,. . -r: r ,i
I (VJe) . certify,�that on,tha"Istiday.ot-M !20
/.. 1 -„_.. ,-.,_,..- .—
I(We) occupied as our ' cipal place of residence lhe following d s bed real pmperty for which a Homestead Property T�c.Credit is'hereby daimed
❑ I(We) owned ❑ Are buying under contracl �
' Have a benefidal interest in the entity tha� is liable tor ihe property taxes on ihe property and that owns the property or is buying under a contract.
11 buying om m�UaG, Fee Simple ownefs name
RecoNers olfice whera wnUaa is remrCed
If any portion ol the residentlal sWCtura w
ot Ihe properry utilized w produce income.
7o.mship
not
Record number � Page
Is the
11i1J�����A �R�WODeM ❑MobileHOmo(I.C.67.f-n
ane (1) aae Ihat immeC�wrtound�ctura is used to produce income, Eescnbe Ne use and portion
�a�.���_`�53;�a�����-,�'`�'3��'x���-,�''.-;STAN�AR�`DEUUCTION'AL'LOWANCE«y �'I'1�6`�.'�i��s`..'�i3�"�`-"nr'"�-='�k'�'s�`��^'x
20 _ Pay 20 _
Lesser of 1/2 Homestead $
vaivauon or E35.000
Signature of Auditw � Date signetl