Homestead_Montgomery (3) • • STATE FORM•t.t„tie 'T MEASURE,FORM TSIA IPORTANTtNOTICETOHOMESTEADP PROPERTY 0.OWNERS Gibson County Auditor 101 N Main PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes more beneficial,there is more incentive than eser for homestead fraud.Homestead fraud causes higher tar bills for all:therefore. • HEA 1314-2009 requires taxpayers who receive the homestead standard deduction to Geri v that they are eligible to receive the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filings.This information will he kept confdeniial and ran only be accessed by au horiaed courtly officials.The Ikpanncm of Local Government Finance will e e this information to create hods that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Montgomery, Roger 402 N(lull d Fort Branch IN 47648 7697 Roger Montgomery 402 N Hull State Parcel Number Legal Description Fort Branch IN 47648-9709 1t1tt 11tr r1r11rt t1tr11rr 1r1r1rr1tttillrrrirlrrllr rrrr 1111111 11 26-19-18-302-000.531-0267011-00531-00 HILLCREST 79PT PART 2:TAXPAYER INFORMATION Owner I First Middle Last POdthert- e rnONT9oMP21/ ng.Address(number and street,city,state,and ZIP code) - - — J Same as property Odd/ass I ---- - 9'O2 NO2zk R z c- 1,r:.r Ba,►7k TN' 4176,ye _ Spouse First Middle Last Mailing Address(Number and street,city,state,and ZIP code) El Same as property address Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below) sat 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 r � Date • wwn Hc ia ism HescriGeG By State Bwrd of Tax Commissianers CLAIM FOR HOMESTEAD PAOPEflTY TAX CREOIT FOR YEAR 19 '79 To & FIeE in Wplicaro SEE BACK FOR FILING INSTRUCTIONS D//�OD��� �a �(We) ����-�-Q-Q�.- c rtify that on the 1st day of arch, 19�, I, ( e) occupi as our pri cipal pla of residence the following described real property for which a Homestead Property Tax Credit is hereby being claimed: I, (We) ❑ owned ❑ are buying under contract ❑ have a beneficial interest i tn he taxpayer Ca-f' � Property Description in j-k-�-`-��� County ��-�--e�- Township Taxing District (GiEy; Town,snwnship): �'�- —�/t-a_.._._-G.. Parcel Number or legal description shown on tax statement: ��e.� 7 9 �IJ �2 If buying on contract: Owners name �'� :�mo�e ow�e�i Contract recorded in Recorders Office - Record If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of the property utilized to produce income Any other counties in which individual owns or is buying real property: County Township �°sE✓ �' rn�th hereby certify the above statement is true, correct and complete � a�a ' Individual either owns or is buying under a contract that provides he is to pay the property taxes on the residence, or has a beneficial interest in the taxpayer. - FOR ASSESSOR'S USE ONLY - Land not exceeding I(or�) cr i�iTqed te surrounding residential improvemen�' Other Land JUN 1� 1979 Total Land . Residential Imprc�e,n � Other Improvements i i �. � •- Dwelling Garage Total Tm ' Improvements - Line (6) pius (7) equals (8) I,�by certify the above is true. correct. and complete. � „ _ . Signamre ol Asxssor True Cash Value (�) �e o (2) (3) �(oo (4) ,�-�>/�" (s) �03 crO (g) �r='"'= (�) � �g� i o - ACTION BY AUDITOR - Assessed Valuation 3 za 3 Zo � a �� �v'. %��� Homestead Valuation . jj��jjjjjj j/��/���j /�jjjjjjjj/ iia/// i/ // /�%17���//a:i S�2- �f � 7 y Date Date: �