Homestead_Loney AM£FORM.)•A nC t uw1 IAFAARER fOBA41A
APrMw En BY MATE BOARD nrnrt_TkITS.S.M PRFYAIBID&Y mr orrn0.neer(F LOI:ALCMaLNMFfl FINANCE IC 11-1.1-22-E.1
Gibson TONI Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main• PRINCETON IN 47670 Individuals and married couples ate limited to ore homestead standard deduction.As the receipt of this deduction becomes.
more beneficial.there is more incentive than e'er for homestead fraud.homestead fraud causes higher lax bills for all:therefore.
/ HEA 1344-2009 requires taxpayers who remise the homestead standard deduction to verify that they am eligible to recene the
benefit and to provide additional identifying mtomuawn necessary to allow county government to better monitor homestead
filings.This information will he Lelr confidential and on only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create owls that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Prnpern'Address
Loney, Michael USheila D 1 /
7941 S Andee Ln /�!/��
FORT BRANCII IN 47648
2984
Michael L Loney
7941 S Andee Lane State Parcel Number Legal Description
FORT BRANCH IN 47648-1548
ltlnllntlrllntlnllulnullr lrliIlnliulnlnlut���n1tl 26-19-19-103-001.201-02�SOUTHGATE 15
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.
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
M(° 4,1-'1-- LEE LonIEV
�g Address(number and saws,city,vie,and ZIP code) t, as property address
Spouse First Middle Last
5HeJLA 7EREi-IEA LoeuEY
Mailing Address(Number and street,city.state,and ZIP code) Erame as property address
_------ - - '
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 nature Date
0
CLAIM FOR HOAAESTEAD PROPERTY TAX
' CREOR/STANDARD DEDUCTION
s� ro� sars �� i sos�
Presabad by Ihe De�A af Loral Gouerm�ard Frwke
INSTRUCTIONS: See ieverse side for fil'mg ins6uctions.
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�(yye) � i , V�/� �` \� � e��2� Q� �% )cerBfy C�at m� of March. 20_
I(We) ompied as av pr'vidpal plarc M resider�ce the toBowirg desaibed real pvpeAy tor whirh a HmiesOead Properly t is daimed:
�I M/e) owned ❑ Me buyug urda contract
Have a nenefiaa� mm�st in me ensry mat is �iade ra me poperty raxes m me p�paly and aat owns me propeny or is tu�m�g unaer a contraci
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tt dy"rg om m�trad. Fee Si�le amets rema
�atl�s of6ce w�ae mrWad is remded Remd numher Page
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ne�y po� or u,e � sm,m,e a a�e �a mwe�� c„ ac� m�:�„es�y a,�m� u� p �eea m v�a,�:�b. aex,,m u,e �e a�,e pamn
a me praperty wiimd m pmmue uimrrie.
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Counry Tumship Counry Township
I hereby certi(y the abwe sfatements are We. cortad and carplete. �°B d damaa
(nurter m�d afreeC oA'. 9a�. LP ooee)
� � . � " � ' ' ' � TFg1E TAX fASSESSED VALUE FW�STFAD`' � �^' rY NON�IDH:TIAL `��t�
..:iit�.. � t�INiU3EOpLY„_{. � �i� ���",:' rVALUE�:e�<< . �AT�1����TTVa � �;�,'�,YALUE f�i...i :�f�d,c4i."z�i:VALUEA�i..Ek:�"w�c.
..LerW nd e�ee6ng 1(a1B) aae imnedately ' s����'� �; i}� l� � �Fs :,3` '3c" 1;f'";{
(1) . �Pr,�1'�; }"a. �.',�na�<:��'Si4nA,
s�around'vg residential improven�ents. ��i::,"va� ,�'���,.�?.r:,.�a�Z::v.,�;,1,.-,'�S?-zr:,s..:a:
VYIOI pIN ��/ ' iki��{� �,Aif-�:
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Td� land (I'v�e 1 pkrslme � ig)
!���CfY� { 4 {(_\�A �(� � � . l'� . p��� f �!2
VAVW"O ��� �i� l!t�i';��l�l �} dtiJi "i�E✓�s�
Resdential unpfovements orMrwaly �; .3.��L3��,f ..r..�� .r_aF,.s ......a..�_.MC.. r�{.?
. )�i ,}�� �'.� y,s� i:
ASSessed Alahlle / At�Bed FIOrt18 ��e (5) `r ��� � ���'�}`�''� r'�' '}� + ���.�
�.n:.4S...�+?r_r.=�.a.. t�..
'^ r�t � s...
Otlie{'unpmements (6) .� .:..�
Tdal'unprovemertls (ime 4 tivou� Gne 6) (7)
Tifal value (I'nre 3 pda 6ne n (g)
I f�eby ceAify Ihe ahove is true. cortect. and Sienamne ofnsae.sso Date a'gied
�r�lete.
�h��8 adfan - Si�sWre oF/uMSmr Date nipned
2(1 _ Pay 20 _
Lesser of 72 Homestead
Valuation w f35,000
f
Date sipr�ed