HomeMy WebLinkAboutHomestead_Pegram MIT t Olt M 535t.IR:1NM1 TREASURER FORM i}IA
.APPROVED BY MAIL&ARO OF MTv*LTS.`PS PREARmED BY 111r DEPARTWNI OF LOCAL GOVERNMENT FINANCE Mt-1.1--_J.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
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 ever for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
® HEA 1344-2009 requires mtpasers 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 ro better monitor homestead
filings.This information will be Lepl 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 h:Ip county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Pegram, James P/Kelly L >Y"--s.
7913 S Andee Lane
FORT BRANCH IN 47648
2988
James P Pegram
7913 S Andee Lane
FORT BRANCH IN 47648-1548 State Parcel Number Legal Description
IIIIII'111lllllttl11I1111111IIIIIIIII'llllllllill.. III'lllll 26-19-19-103-001.205-02�SOUTHGATE 19 ,
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
comes Maga� PauL &RA-Th
'nu Address(number and strut,city,state,and ZIP code) 111- rne as property address
79/3 S. I)Ndee to nE Fort Bench / Z/76; cc •
Spouse First Middle Last
& L L y L yv�/ 670/9-m
Mailing Address(Number and street,city,slate,and ZIP code) I�-&i nle as propene address
79/3 6 ,wdEc th ie branch c/7Co V 2
-- . '' PART 3:CERTIFICATION 'v.' ' ..` ' —r - • - - "
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 fable for back taxes and substantial financial penalties.
Owner I Signe \ Date
.
•
I �.
/ �
CLAlM FOR HOMESTEAD PROPERTY TAX FoRCfl
CREDIT/STANDARD DEDUCTION HCto
smm r-«�,� srr.� �� i sos�
P�e�bed by u,e oe�trt�a or �ora� Go,ert.'era Fn�
INSTRUCTIONS: See ieverse side for filing instruc&ons.
' � ' - ' CHtTIFICA STAIEYFM � � - , -9. -.
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I(We) �" cer6y that on the 1 st dey ��: 20 .
I(1Ne) oow � as our prindpal plaoe of r�idence the 'rg d real (ar which a Hanestead Prop�c Cdedt is hereby�dat�-t�'ec
��(We) ❑ Mebuyugundamntrad ` 1 '� <:,r.�
� Have a benefidal inteiest in Me entily that is liade fior Cie pro�eAy �ces m fAe p�opaly arM Cat owns fhe pr�s bu�m�g under a contracL
tl buy"og om m�tracl Fee Sirtryle ownafs �ame
Wamrdds al6ce rrhae mrllad'u iemdad
Remrd number � Page
* . . `�� -1'.fi....e .'.PROPERTYDESCRIPTIOi'1�;:', �,.^isy, i,'>.. `'�� �.T.;'{_v °... :>'!'::���}!
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Cqimty TuvrsluP Tamg dislricl (riy, 6�wn. fo�nship) �
Pa,cei nmma � Le9� dewiPtim la Ma poperty n .
� papaty ❑ Mahib Fiortia (LC. 67.1-� �
H arry P�� of the resideNial struc4se a Ihe Imd nal ��eNng ane (1) aae tl�af inmed�ely amou� U�al atru.4ae b used In Woduce i�mrtie. dea�be the �ne aM pation
d Ilre prapnty Wif�d b pfomre c�mrne. .
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,:: PaorExrr ow►�m sr cuvwnNr a oni�rs cou�s' �, ., ' r.�� .�; F,'; " 3�
�fii&r..ri
County Tumship County Tornship
I heieby certify the above 5fa�rnenCS me true. corred and corryk�.
(nurne.endatreet dA:9am. z�oaee)
�. � �" ASSESSOR USE ONLY t `y ��(S, ; t'i TRUE TAX'� 4- ASSESSm VALUE � Fm1�STEl1D.. �� rz�t�NONatESIDENML°�=4' t�
'e' ;:^ v...�a� r i�Ht��. cVALUE,: < -AT,700%OF�l7V��l.kdVALUE.r'���, _� it.��';•���YALtJE_�,`.ts hi4�'.4
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LarM rat ezceedrg 1(one) aae imnedaffily (� � � Y�.�t`�"�;�c��+�,`� ki-�'�'�itiy;'�ri� k�
�d'sg residential impovert�enCS. .y : .^,�..ci:iw`�s '�x'��:�'�a'��''.��
Otherlard (y) '-'�f,i.�; ���'
dr''
TU� land Q"vie 1 pku !'are � (3)
� S Si 'hyhM"� {S �' � C rY+�`
OMelfi 4 �^�� V3'��i��CS ��„'Yg%''�..i+�x'kL�'`}s
RBSidenfialvnpfvveme��SwMrwelly �9 ( ) t as<.,3`s',/� �iu�' .iY'.Lw.+�,.
� Mahle 1 Ataratfa�taed Flane h�s�.�' .rf �`� "�i •�
� I +c �'R°' a S`MP t (,.
Ga29e (5) isbi�a�+��'�.'cs�eaSiF1+.� }���'�'F>t�,d�•l�'•
t4M5.x.Sle4e�}.Ji � r35 1 ��?.I
Olher vnpfOV¢menf5 (6� s . .. �1,.f .,! . .� .
•r+.
Tdal 'vnprovert�ertls (6re � ltvw� 6ne 6) (7)
Tiial value (1"are 3 pds ffne � (g)
I he�eby ceAi(y tl�e abwe is Gue� mrted. ard 59�� oFASacssar Dam sip�ed
complete.
vaiiyirg aaian - Si�eme ol h�m. Date ssi�pied
'. -•.._-; .. •• ..' '��.STANDARDDFDUCTIONALLOWAXCE.r ''zr� �.:.ii�. .ie:..`:i� ...�..5�;<��f&;'w2<
20 _ Pay Zb _
Lesser o(12 Hotnestead
Valuatim or 535.000 f
s�e aaeim. � �