Homestead_Johnson (11) _ . MATE FORM.,K,IC'r hind MIASMA FORM 73-1A
K APPROVED BY MATE WARP OF A 1ULATs.'-m.0 FRFg,UBFD BY nil DEPARTNEW OF LOCAL GOVERNSIMT FINANCE IC 4.1.1•2:4.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
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101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one homestead srandanl deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than as for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
, . HEA 1344-2009 requires taxpayers who remise the homestead standard deduction to verify that they am eligible to recent die
benefit and to provide additional identifying informmwn necessary to allow county ei nem-nal to better monitor homestead
filings.This information will he kepi confidential and can only he accessed by authorized colony officials.The Depanntcnt 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
Johnson, David M/Vickie M
!Ivey 168
Pon Branch IN 47643
7688
David M/Vickie M Johnson
607 E ParKST State Parcel Number Legal Description
Fort Branch IN 47648
26-19-18-302-000.375-026 /011-00375-00 HILLCREST 5
PART 2:TAXPAYER INFORMATION
Owner I First Middle T Last
Davio1- RRlc-hael 1t oknsay,
ng Address(number and street.city,state,and ZIP code) k.�-t Same as property address --
607 Et Park 51-. - Fort Brands TA/ 97011B'
Spouse First Middle' Last
VI 0I( e, Marie_ jo h n s o n
Mailing Address(Number and street,city.stare.and ZIP code) Same as property address
66-7 E. Park St, - Fort g rartc ■ 3 TN 47(0 y8'
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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
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nroo°..rty
CLAIPi FOR HG��STEAD P�0°�tTY TAX C_�IT FOP, YFJ�R 19��
SEE BACK FOR FILIN INSTRUCTIONS D// DD✓ �S �O
/ certify that on the lst day o:
I, (p7e) occimix3 as our princioal ace of residence the folluaing descri.tpd real
which a F3o�rest�d Pmp°.sty Tax 't is hPSeby beinq clai�reci:
I , Q�'e ) [� aane3
� aze bv�inq unier contract
� have a ben=iicial int�� �st i/n the tal�mayer
Pro�rty Des^rintion. in ,�i�C•�L•,-yrJ Nwzty
Taxing District (City, Ta:n, Zbwnship) :
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D�.ol tn,,..�.� or legal des�intion sho�»n on tax state�nt:
I%��Cit_� � J�
I= DllV1P.7 om m�tract: Owners n3n'e (f°_ sirr�le rnm:s)
Co;,tract rw^ords�i in P°�rd=r's Of=ice - i�-cord tb. Pag=
Z= any noruon of the r_sidential stn:ccure or `he land, not �e�iing or.e (1) acre that
i;r�tia�ely si�o�s ti�at structure is use3 t� ozvduce incan=, d_scribe tt:_ use arzi oortion o�
tne nrooA._rty utilized to produce incoire
Fn:� o�her �Lm*_ies in which irxli�2d•�al cxars or is buying r�..al oro�._rty: Colmtv �tr.anshio
the �ove s`at�rent is true, �rrect ani coml°t°• �
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'Irxiivid�l eithAr a�ns or is buYin4 �m°r a wntract that provids he is t� oay '-�h_
n�v�_rty tax=s on the residence� or has a ben=iicial interest in the ta.nxyPS.
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Lanl not e�c�eding 1(one) acre i.c�c�diately
surrourriing reside� ��?}�gnpnts
Ot�er Lana � �' . ,
To`�al Land �j 1�1R'�FRt
P�sidential Irrnrovements R.,•elling
Garaae
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