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Homestead_Sands• tlitE FORM a(!•IR.I WW1 lIttASUIER FORM SIA .A IPKOVED BY grit.111V,0 OF 4�iRt lc,_ytv PRrYRIBED BY TIE DEPARTMENT-Or LOCAL GOVERNMENT FINANCE ICH.IS]J.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 ner for homestead fraud Homestead fraud causes higher tax bills for all:therefore. `. HEA 1344-200Q requires taxpayers who receive the homestead standard deduction to verify that they am eligible to reeebe the benefit and to pltc'idc additional identifying information necessary to allow county goverunrot to better monitor homestead lilinga.'Htis information will be kept confidential and can only In accessed by authorised county officials.The Department of Local Goverment Finance will use this information to create crols that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Sands, Robert E/Toniann 1 100 W John /`4/ Fon Branch IN 47648 6795 • Robert E Sands 100 W John St State Parcel Number Legal Description FORT BRANCH IN 47648-1006 26-18-13-402-000.680-026/ 011-00680.00 WALLACE 8 FRENCH I I u II r II II ul I n II I nu II II uI I I Ind II I I eo II nn IeiII 280PT/281PT PART 2: TAXPAYER INFORMATION Owner I nn First Middle Last f5o be rt" edcrword <14d5 -- - - -- ling Address(number and street,city,state,and ZIP code) E 'S�eme as property address - - /oo W. .r0 - f BraNch, .rM z/7,yg Spouse First Middle Last Mailing Address(Number and street city.slate,and ZIP code) - • El Same as property address Social Security Number(last 5 digits) Driver's 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 infonnation 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 • FOflM HC 10 19i9 Prescri�eE Bp S�ate BoarE o� ia. Commissioners CLAIM FOR HOMESTEAU PROPERTY TAX CREDIT FOR YEAR 19�� To & FiIM in Duplicate SEE BACK FOR FILING INSTRUCTIONS D// _4� �� (We) �� 1f' ^ �is/ certify that on the 1st day of arch, 19 I, (We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby being claimed: I, (We) ❑ owned ❑ are buying under contract ❑ have a beneficial inj�r�st in the taxpayer Property Description Township Taxing District {C� Town, �.sk�% `r��- • � n �-� �+� Parcel Number or legal description shown on tax statement: zv � �-. Q�'-oQ.. � �v � � � -78'/� If buying Ofl contract: Owners name ��ee simoie ow�erl Contract recorded in Recorders Office - Record No. Page If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of the property utilized to produce income Any other counties in which individual owns or is buying real property: �hereby certify the above statement is true, correct and complete. County Township 'SlgnaNre Stteet AOCress � Ci:y. Staie antl Zlp Cotle ' Individual either owns or is buying under a contract that provides he is to pay ihe properiy taxes on the residence, or has a beneficial interest in the taxpayer. FOR ASSESSOR'S USE ONLY - Land not exceeding 1(one) acre immediately surrounding residential improvements Other Land Total L� Resident� ImQrove� ts � � � ii!_ �'> 1.9i9 Other Impr meqCs Tr•-�, Im e �Ms 1 ��by certi(�the Signamre of Asseswr Approved Dwelling Garage Total (7) equals (8) correct. an� complete. True Cash Value ��) 55�0 Assessed Valuation ,� . . . I - = � ��/ �• � • %��/,/"'/�..�-%%i ! � I (7) —o — ($) � - ACTIOYd BY AUDITOR - i� Homestead Valuation ., /�jjjjj�� jj��j�j �� /��/// /�/.. �.: � i J-a � - 7� Da:e Date: 13�