Homestead_Nicholl SITE MMASI•1!MI12/f■MI MASntfl HWY 75-IA
amEIMPORTANTTNOTICE TO HOMESTEADEPROPERTY 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 dun ever for homestead fraud.homestead fraud causes higher tan bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
finings.This information will be kepi confidential and can only be accessed by authorized county officials.The Department 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
Nicholl, James B/Anita E
-
209 W Walnut
Fon Branch IN 47648
2540
James B/Anita E Nicholl
209 W Walnut State Parcel Number Legal Description
Fort Branch IN 47648-1335
Irinllntlrilurinlln lnnllulinrllu it itilur1r1r r11url 26-18-13-404-000.482-026 '011-00482-00 MCCRARY ETAL 59
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
C/.4-1/4-i et-—C r) M 1 014'0 1 1
' e Address(number and street,city,state,and ZIP code) Same as property address
c� �j l Al . W 1 n� u. ; -ST
Spouse First Middle Last
AM-1 t -A d- JU , LI , 0 I I
Mailing Address(Number and sweet,city,state,and ZIP code) la$enle as property address
PART 3:CERTIFICATION '
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature rate
i�'�'�"" - CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
����� State Fortn 5473 �R21 S92)
•�.%
fi INSTRUCTIONS: See reverse side for liling instructions.
FORM YEAR
---HC10!_ `—
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.F� �' E ; i}6 ` ��
�• � P. JS ..� . %
CERTIFICATION STATEMENT I�IHT 1 U LUU
I(We) ' ' ce ify that on therlst �ay of Ma�fc/h,� �
I(We) occ p d as our principal place of residence the following describe real property or ich a Homestead PJoperty'Tae Credit�ishereny��ned:
n x L.,-�....J-,�� �i . � v .
❑ I (W ned ❑ Are buying under contract � � `NQLL /' 3'r ^��� ,"� ;�,'-'.' }.C7iTC�.
❑ Have a beneficial interest in the entiry thai is liable for the properry taxes on the property and thai owns the property or is buying under a contract.
CONTRACTRECORDED �
If buyirg on contract, Fee Simple owne/s name
Fecordefs oHice where conUac� is recor0etl � ' Recortl numher Page
PROPERTY DESCRIPTION
Counry Township Tazing district (dry, town, township)
P Inu ber Legaldescription �+ �
�J
It portion of ihe resWen6a1 sUUCNre or Ne lantl not eaceeding one ( acre at immetliatey sun at swcture usetl to prod ce income, describe the use and ponion ot
Ne properry utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES �
Counry Township - Counry Township
� nature of Gai� �
.ereby certify the above statements are true, correct and complete. `
Ad re$f�(number alld str@eI, iG ry, gldle, ZIP cpde) ���
CJC �/ ll-J
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON•RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately �� �
surrounding resideniial improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvements
Garage (5) -
Other improvements (6) -
Total improvemenis (line 4[hrough line 6J (7)
To�al value (line 3 plus line 7) (8)
I hereby certify the above is true, cortect, and Signawre of Assesor Dare signed
complete.
Verirying action - SignaWre of Autlitor Date signetl
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead �
Valuation or 52,000
Signawre of Audiror , \ Date "�etl/
W