Homestead_King (2) • Sl\tE FORM!Mt.1K II-11.1 TREASURER FORM 79-1A
ArrR'n'En BI'STATE°nomrf nenOiNns.N.Y PRrARIPFD BY no DEPARTENT OF LOCAL rOVERNMrNTN:ANCE IC 1.I.I-2_4.1
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 monies
_ more beneficial.there is more incentive than net.for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taspavers who receive the homestead standard deduction to verify that they are eticible to receive a the
benefit and to provide additional identifyint information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only he accessed by authorized county officials.The Depanntent of
Local Government Finance will use this information to create tads that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
King, Jeanetta
503 S Center
Fort Branch IN 47648
7844
J anetta King
5�3 S Center State Parcel Number Leila! Description
Fort Branch IN 47648-1505
II III I II I II I I I I I I II III I I 26-19-19-101-000.486-026✓ 011-00486-00 PRITCHETTS ADD 237
to tit t Inn iinn rr r tot rr t tit
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
mg Address(number and strict,city,state,and ZIP code) - �- - _ - Same as pm m lidtii¢; "— '— — -
4 3 t_ e E 47/2--E- Sr � -r E�h�7 47/7 ,sser
Spouse First Middle Last
Mailing Address(Number and street,city.state.and ZIP code) ❑ Same as propeny address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sale
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
unla r Ily,he or she may be liable for back taxes and substantial financial penalties.
race I enawrc Date
•
CLAIM FOR HOMESTEAD PROPERTY TAX
" CREDIT/STANDARD DEDUCTION
t-�- f Slate Farm 5473 (R5 / 10-0t)
�� Prescribed by iha Department ol Local Govemment Finance
INSTRUCTIONS: See reverse side /or filing instructions.
I (We)
I(W�occupied�s our principal ptace oi residence the fol�ng described real property for which alFlomestead.P"roperty Tac �Credit is hereby daimed:
I(VJe) owned ❑ Are buying under conlract �
��..GIESON e��u' - •
Have a benefidal interest in the entity that is Iiable for ihe property taxes on the property and that rnms the propeRy or is buying under a convad.
FORM
HC10�'`��
�� T�l �7 �\
� ����
YEAR
20_
if buying on conUaG, Fee Simple ownefs name
Recorders o(fim where mnVad is recorded
County
Parcel number
Tamship
�.(��'!�/'//1!!)'YJ 1 ///l�L'/LO//�
H anY Dur6w+ of the residential sWCWra a the land not azceeding one (1) aae
of the property utll¢ed lo produte i�ome.
County
Toxnship
I hereby certify fhe above statements are We, corred and complete.
Address (num6er aM sheef, city, sfate, ZIP cade)
Remrd number
fown,
Pa9e
I Is ihe property'n q on:
� Real property ❑ Mob�e Homa (I.C. 61.1-�
wrtounds that sW Uure is usetl b produca inmme, desaiba the use and portion
r,....�'F �'c.. _ rr'_�.�,:s .. �-.ir � � ; - - "n �'a �y � . _ , '
�`�-:..��� ,�,x�'�,-�?��-;���sTnNOaROneoucnoN�nuowaNCe*,r�`�^: �` - ,� �' . """'�� '�i�3.��r° �
Fk+�-C 3-. c C .v��E it�s�S�..t���-�'�.%: �u� �4 .«TiS�[A2...
20 _ Pay 20 _
Lesser of 1f2 Homestead
V�uation or $6,000
$
SignatureoFlwdilor ' �atasigneA