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• STATE FORM 53569(N/&1% - MASKER FORM-1;-IA
AP PROM)BY STATE BOA RD OFARVUYIS.YV! - TREKFIBID BY THE DEPARP.£TOF Il%a1.CAVLIMMEWT FLYAYCE IC 61.1.2141
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS '
_ 101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As die receipt of this deduction becomes
Princeton,IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher sea bills for all;therefore,
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they ate eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
�• filings.This information will be kept 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 I: PROPERTY INFORDL4TION
NOV 1 0 2011 Taxpayer Name Location Address
C 'rn°-t.,, Pate, Paul L/Susie A ,
v `\ 105 E WALNUT
GIBSON COUNTY AUDITOR GEORGETOWN w 47122
7040
Paul L/Susie A Pate IIIDII HIND MIIIDIII_oin111 II0II11II_II_IIImuII[I1II111illnii]ImlII11II
1502 Lakeland Dr
Georgetown IN 47122-9105
IIIIIII11111111'II'11111"IIIIIII'II1III11111III' 'IIIIIII11IIIII State Parcel Number Legal Description
26-18-13-404-000.588-026 OLD PLAN 10
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:
— —_-d----___._FART 2_TAXPAYER INFORMATION ____ __ __ __-_ —
O. I First Middle I Last
Mailing Address(number and street-city,sm ,and ZIP code) c as property address
1 05 CPRWoArcc- 4- cm,bllAtAA-ticouks-
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 Date
PART 4: ADDITIONAL INFORMATION
C cmliva,cx g t,nri2QP 9 _.6.- zoo -7 # 7,7 .-3 g-
/
_ CLAIM FOR HOMESTEAD PROPERTY TAX FoReA
reaR
CREDR/STANDARD DEDUC110N HC10
smm ro� ure rta i so� ����
Preavbed by Oie Dep�bnanl af Loral Goramad Frw�oe
�NSrRUCnoxs: s� �� s;aa rw m�y m��am,u.
ti. _; .. •.- • . , : : .� , cnnarsrn�r:� � ,�. . �. � ,. . �,,, : r .�.
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I(We) certify tl�at on the 1 sl day of' M�a�rch," 2'0'_
I ped as aa pr"uma fo9owirg desabed real pvpeAy fix which a Hanestead Propaly Tmc,Q�it�i5 �artned:
�°W^ed � Areby'°gurd°°°^trad GIBSON COUNTY UDITOR
Have a benefidal mierest m the entiry 9�at is liade far fhe propeAy tazes m ihe property and O�at wvns Ihe properry or is buyu�g under a oontrac�
ca,�b I T°�'�aP � T�9
�� �m�, I �� a�,�„ �/ ��if'I °�"� � �,
❑� v��r ❑ Mon�a rwme c�.c. s,.,-n
x ary poruon au,e r�iaerNai swmve a. ma tmia na m¢eedrg a,e (1 � nvl:nmadatdy e��sMS m� am,m,e is usm m pmm,ce :imna. aesobe ma ine mid puUm
d Ma praparty �IDFmd In pmduce u�mme.
a�-l�-i 3- �o�- a�,`5��-oa lo
� �. , _ ,: __ . .
R.,.,�r, . ? �^;," . ..� A':r: .._ :1.�`,`�?..?I�PROPE7tfYOWNED��BY.ClM1ANTOi�07H92COUtiTff3�....-,-:.' ' ^;fyr��?z'�3h„r�:,�:i�xo,U�t,.`,�:'�i
Caunly Tomahip Caunry Twrmhip
I hereby certily the above Sta&rr�ents are true. carteG and conplete. �` ��I °� �^ `�/r1.�6'
1}((�qi,nl. r
(nu�te. ene atreet aA: �m. z�mde)
� : �� � • a. -: � r . c " �r {�`y� "'``� TRUETA7C t �` 'ASSESSED VALUE ,i+F10i�STEAD� w e �ri � NON�RF.SfD6iTU1L���9�
lr ..,� �ASSESSOR USE ONLY . .jv �5s � , yp�,VE� -'AT 100X OF TTV ` VALUE t ` � � °�` �. YALUE "" Y+ �y. �
. a.. .s. 4. �-+ .a`� ...'a. ,�. r.'.�.. ..N.,a.. � �., s.,�r�. .re..G.a,. ..r.:
Land noi exceedng 1(one) aae irtmeda�ly.. -. � n a� l��;J'""`� �t, '�+ Fcr�+�'
s�u,amaoqreslae�tialimpo,�nenh. (�� :a,�.`l�s�,€�axr�"'f�s��'a'i�.'.'�� x'�n�?�
.. �.:
�IBi�3fld r" I 4Try-'F.
�2� �, n'�ftfi�r: b'ty'.;
TAaI land Qcie 1 phu 6re � ig)
��' kl� `a�`-' � x"S..rca4"'�i„cLitii=`,'i`.
Resae+,eal'vrqnwec,eMS«anrwaly °�"9 �4� S`T'�t�,����;"��k�'��.�,€��'�`
�558d �C � �lCd �'�Qf18 f A,�, N '�1+z �.14'�`t N ���'a.al v;! �,���( �'
��e �5� ."�n{'���y��+5h4ydf i%�� }�t5'"�1�,.
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VY'CI rtflplWEfI12fILS (V) �. t ] J � i
'aks'd,a%:�„°?x� i_a'", y..
Tdal nr�prwertiertls (!vre 4 Wotx,p, ine 6) (n
Tdel value (1'vie 3 phs 6ne � �g)
I flereby oertiy ihe above is true. mrred. ard Sie� ofAsams« Dale sipned
tm�plete. .
Yeriyirp aGWn - S�mIIUe oF Audmr Qete sigrwd
.!.._�. ..>. . T'J;'.7^�'°.�STAMD/UiD:DEDUCTpN/tLLOWNfCEf . �'.(F ,�.�".�d��t,:,'"�r`�:w,.'". .{�.��"��$.i�t�F?:fi
Nl _ Pay 20 _ .
Lesser of 72 Fbrtcstrad
Veluation w t35.000 S
Sigahoe af /4�&Inr �ate aipned