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Home My WebLink AboutHomestead_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: � H. PREPARER Preparer of the Sales Disclosure Form Title Matthew Jarvis Escrow Office Company E-mail address Telephone number Southwestern Indiana Land Title matt@swinland.com (812) 425-0055 Address (number and street, city, state, country, and ZIP code) 605 SE Martin Luther King Jr Boulevard Evansville IN United States of Amenca 47713 I. SELLER(S)/GRANTOR(S) Seller 1 — Name as it appears on conveyance document Seller 2 — Name as it appears on conveyance document Shalonda Maree Newcomb John Lawrence Perkins Address (number and street) Address (number and street) 913 Mohawk Dr. 913 Mohawk Dr. City, State and ZIP Code City, State and ZIP Code Fort Branch, IN 47648 Fort Branch, IN 47648 Country Country United States ofAmerica United States ofAmedca Email Address I.Telephonp Number Email Address Telephone Number h 8 o 664 n Untler pe so perjury, I hereby certify this Sales Disclosure, to the best of my knowledge and belief, is true, correct, and complete as required bylaw, d Is repared In accordance with IC 6-1.15.5. A person who knowingly and intentionally falsifies the value of transferred real property, or omits far ' any Information re#plmdtobe provide commits a Level 6 felony. Sign S r tof Sign of Printed a of Seller Date Signed (mm/ddl nrded Name of Seller Date Signed (mmldtl/yyyy) Shalonda Maree Newcomb YYYY) John Lawrence Perkins 4/14/2026 4/14/2026 J. BUYER(S)IGRANTEE(S)- APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL THAT APPLY Buyer 1- Name as it appears on conveyance document Buyer 2 - Name as it appears on conveyance cloaftt Jillian C. Moon Daniel A. Moon Address (number and sheet) Address (number and street) 807 Creek Dr 807 Creek Dr City, State and ZIP Code City, State and ZIP Code C, Fort Branch, IN 47648 Fort Branch, IN 47648 Country Country OO 026, United States ofAmerica United States of America 4Q Email Address Telephone Number Email Address hone Number (812) 881-1977 AS, ) 632-1494 Pursuant to IC 6.1.142.44, the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that aw. YES NO CONDITION YES NO CONDITION 0 ❑ 1. Will this roe be the bu ees rime residence? 0 ❑ 3. Homestead O ® 0. Solar Energy Heating or Cooling System ❑ 2. Does the buyer have a homestead to be vacated for this residence? if yes, provide address: ❑ 0 5. Wind Power Device ❑ 0 6. Hydroelectric Power Device Address (number and street ^ t ❑ 0 7. Geothermal Energy Heading or Cooling Device City, State, and ZIP Code County oZ(v-19-18-101-001.119a-:oRCQ ZagUnder penalties of perjury, I hereby certify that this Sales Disclosure, to the beat of my knowledge and belief, is true, correct, and complete as required by law, and is prepared In accordance with IC B-1.1-5.6. A person who knowingly and Intentionally falsifies the value of transferred real property, or omits or falsifies any Information required to be provided, commits a Level 5 felony. (Note: Both spouse's Information, SSN/Orlver's IlcenseND/Other Numberis neeessaryifa Homestead Deduction is belno Aled.1 ignal uyer'L,Signa of Bu r S se Pnn Legal Name of Buyer 1 Sign Date (MM/DD/1'Y) Printed Legal Name of Buyer 2/Spouse Sign Date (MMIDDIYY) JilliOYC. Moon 4/142026 Daniel A. Moon 4/14/2026 ast 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number Last 5 Digits of Buyer 218pouse SSN/Dnver's License/ID/Other Number SSN: $ �-Xy D41 one lgq7qSSN: $`6`1q eC "N % 0 #7 Page 3