Homestead_Robinson (5) -. STATE FORM'SXA Oal..." MEASURER MICA:]-IA
AMCWEf BY SLATE IXNXpfr/el XLC6.`vv Par9R1BEm BY m[DEPARTH`4T Of LQTL CA»ZpIME7a FINANCE IC 41.1.1-2:4.1
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 eser for homestead fraud.I lomestead fraud causes higher tax 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
tiling.This information will he kept cmtideruial and can only h accessed by authorized courtly 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
-- Robinson, Marc A
402 S Center
Fort Branch IN 47648
7827
Marc A Robinson
402 S Center St State Parcel Number Legal Description
FORT BRANCH IN 47648-1504
_ 26-19-19-101-000.092-026 011-00092-00 PRITCHETT'S ADD 254
.— —__—I(Itlllllt'1'Ir minion Ill ilililloolltl'I _1-1111.11 —. - - -. "'PT/255PT -----__
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
e-12-C. 4 IJ R..o.i6 t lS-S o a — — —
ng Address(number and street,city,state,and ZIP code) y�"Same as property Bddress
140 S - CCtitt-el.
%
Spouse First Middle Last
, 6/vf_r
Mailing Address(Number and street,city,state,and ZII'code) ❑ Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Sr
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
•
�
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
t sne � sera Ra r so�
w
Prsn�1 by ihe De�trrent d Lool Govertrrierd Finance
lNSTRUCTiONS: See mverse side /orlding insWclions.
CERTff1CAT�1
r FORM YEAR
(� �. ��� HC10
Q �
�(�'�e) � tii th Mie tst Mart3i. 20
I(We) oxupi as aa prmapal place ot:esidence U�e fcfia.ing desmuf.rJ rr�l po�r:!y for which a Hmws ��Pr�'f� �hereby daimed:
C/
�I(YVe) owned ❑ Are buymg under cmtrad GIBSON COUNTY AUDITOR
Have a benefiaal interest in the entity ihffi is liade for the property fazes on the propesty and U�at owns the property or is buymg under a oontracL
, � � : , , � �: . • � � • e.. � :_:r � .,C� CCNTFACT RECCnDEA:i� . :,• -, � • ., _ .
11 huyog am m�tr�acl, Fee Sirt�le wYnefa name
Remrdels ol6ce where m�Uad is recvded Rervd numher Paga
�ry �
ra�m nn,me
ro.�ao
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� u,e
n e�y �m� �r u�e � sm,cn.e w me ia�e „a «ceem�y a,e t� � ac.e ena+°'�7�e¢�y m�
of N u66zed �o omducn imm�e. �
ny � `-�
��.�P� aG �9-�4-�oi �ro.o9a-oa�. a��,�
w�ae�h !J n�m� �„a ��.c. str-n
u�d to p�oduce'r�mrre. tl�ibe Me use arid P�n
. ;, -�; ,} •�"=r:-�',wzoaQmrowermsrcu�nNT:a'oTMQecourrigs.,,F_: . �..>: -.
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Counry TwnshiP ��h Twrnship
� nereny cermry aie anove sraoe�rien� are we. correa ane cortp�e�. �'`m1tB a dmmara
(nurmer �d sheet �'. sbb. Z!P oode)
- . . . . . . . . . . ,,, .. ,:.'STAMDQRA�DES�GCTION'GU.enYaqCP . _ . . : ,. "'+—:.•. ' . _ .. � ��� �
20 _ Fay 20 __
Lesser of 12 Homest�A
Veluation or 5�5,000
Si��aGae dN�dimr
i