HomeMy WebLinkAboutHomestead_Pugh ' STATE FORM 535N,Rj I'-Ii1 TRSARRR HniV RIA
APPROVED BY ATE NtvEn OF Alf :NO rRFNt1&FDt11-nu.DEPARTMENT OF LOCALCOVExyuat r L40CE IC t-7.1-724,1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS:
101 N. Main Street Individuals and married couples we limited to one honxslead standard deduction.As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial.there is more incentive than ever for homestead fraud.4mtnestead fraud cau es higher Las bill,for ell:therefore.
•i FILED fEA 1344.2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
hnelli and to provide additional identifying information necessary to allow county government to biter monitor homestead
filinu.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will ate this information to erotic took that will help county officials eliminate homestead fraud.
. PART 1:PROPERTY INFORMATION-
_ APR 12 2012 Taxpayer Name Location Address
C 3 N Pugh, James Thomas
811NMAIN ST
GIBSON COUNTY AUDITOR FT BRANCH IN 47648
2084
James Thomas Pugh 11111 hill- 1111011-1 11110oo_il111m111 I1.i ilim11-I[III_IIII
511 N Main St
FORT BRANCH IN 47648-1009
111111111"/11"11111101111111111111"11111111"11111111111 State Parcel Number Legal Description
26-18-13-402-000.366-026 PT SE 13-3-11 .30 AC
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.••
..er I First Middle
I Last
James i heman �u r,
Mailing Address(number and street.city.sta:c.and ZIP code) Stoat a property address
Spouse First Middle Last
Mailing Address(Number end sleet.city.state.and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/Statc ID Number (last 5 digits) Other(please specify in Part 4 below)
lr
I I I I I Snit
. . 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 Date
' ( )
PART 4:ADDITIONAL INFORMATION.
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5l73 (R7 / S06)
PrasrnbeO by the Departrtient uf Laol Gwemment Fcianm
INSTRUCTIONS: See ieverse side for frling instrucBons.
FORM � �
HC10
�(WQ) certify that on the 1�il�y o�.�1m`�N,��
I(We) ed as aa prfridpal place of residence the fo0owirg descri real property for which a Homestead PropeAy Tmc G�adjiyt is heleby daimed:
❑ � iWe) owned ❑ Are buying under crntrad �"' �.Q
�Have a ber�efiaal interest in the entity that is liable Tor the property fazes on the property and that ams ihe propert�s��jiG�1m���bR
H Gry'ug om m�tral. Fee SirtQle o.vie/s rmme
I:r^.�� eT-.. :s: ..�or.. : i _.._o= .:
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Toxnsldp
Legal dasaiptim
Record number � Pege
T�mg disLid (rfy, rown, fonrWrip)
@� quation:
1 Reel paperry � Mo6ib Fbme (LC. 6f.
d the Bsitlenlial strumae a the Imd no1 mmeeding ore (1) ecre thaf unmeGately surtoun� Urat ffiu�ae ia used b Wudwe Incorrie. des�nbe the �ae and G�n
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f:�.;%z.�xw�t�'fi��1{i�.?9.d�-;.�i��'�rz,�RYt:Fx? .�;1�.."`.±;CtiSTAHDARD�,DEDUCTION'AL'LOWANCE .��'r.3A-;��:s?.a��S.i�R���;F.'`n�il" .0.h.�'.�"b'�`.sc�ti:.�i..,r.5m'x,^3c�.�.:W
20 _ Pay 20 _
Lesser of 12 Homestead �
f
Valuatim or 535.000 - '
Sigiuhae o1 Audifar Date sipned