Homestead_Smith (18) , • s1AntEORM!JMIRU s-e} 1RFAN[ER FORV1tA
.AMMO PY RAIE MMnaF.aNMINIS, uu PREYRInmBY fir IDTPARINIMT OF le:A rsvrtNsl Nn FINANCE MHY2Y1.1
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.Homestead fraud causes higher tax bills for all:therefore.
Ask-
IMP HEA 13-44-200‘)requires taxpayers who receive the homestead standard deduction to.erif,Y that they arc eligible to remise the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
flings.This information will he kept confidential and an only be arrests cd by authorized county officials.The Depannient of
Local Government Finance will use this infornation to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address-
_ Smith, Fred T/Ritajean L
903 Blackfoot DR
Fort Branch IN 47648
7612
Fred T Smith
903 BLACKFOOT DR State Parcel Number Legal Description
FORT BRANCH IN 47648-9509
II III I II III I I II I I II II ' I I 26-19-18-101-001.021-026 5 021-00 LITTLE YORK VILLAGE
I n n1 1 n1 a n 1 1 n1 r 1 n1 1 st 11 1 1 ✓ 53/54 PHASE 1
PART 2: TAXPAYER INFORMATION
Owma I First Middle Last
Fr tot F J/17 i-Pti
Ong Address(number and street,city,state,and ZIP code) — - -- - -- 2-,1 Same as property address --—
903 3 / e + Dr. Fort £n2mck //t/ Y76 fg - 9sv9
�
Spouse First Middle Last
Aa ,C ,Son ;l
Mailing Address(Number and street,city,state.and ZIP code) ® Same as property address
9903 ,B/ack4/ D Fri- Qrtnth
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 Si attire Date
a� �? s CLAIM FOR HOMESTEAD PROPERTY TAX
z��'� CREDIT/STA�dDARD DEDUCTION .
�:;;� State Form Sa73 (R2 / 5-92)
uu
INSTRUCTIONS: See ieverse side /or tiling instrucfions.
" " . FORM
HC70
YEAR
e) �� yULA-Qf � ��L- ' certify that on ihe ist day of March, 79_
�) occupied as our principal place of residen e4he tollowing scribed real property for which a Homesiead Property Tax Credit is hereby claimed:
I(We) owned ❑ Are 6uying under coniract � . �
Have a beneticial interesi in ihe entity ihat is liable for the property taxes on the property and thai owns ihe property or is buying under a contract.
� CONTRACTRECORDED - � � � �. �- -
Ii buying on contract, Fee Simple owner's name . ' . � _ '
Recordefs ottke where contraci is recorded Record number Page
Counry
PROPERTY DESCRIP'fION �
� Tazing distnci (cey; fown,
Parcel number Le9al tlescnption , � -
�f( - C�(oa.�-00 .
If any portion ot the residential stmcmre or the land not exceeding one �1) acre that immediately surtounds that struc[ure is used to produce i�ome, descnbe [he use and portion
of the property utilized to produce income. .
^ . �
e
PROPEflTY OWNED BY ClA1MAN71N OTHER COUNTIES
.eby certify ihe above statements are [rue, correct and complete.
Address (numberaMSVeet. ary, state, ZlPmde) .
daimant
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
- VALUE VALUE VAIUE VALUE
Land not exceeding 7(one) acre immediately �
surrounding resideniial improvements. (� � �
Oiherland (p) �
Total land (line 7 plus line 2� - (3)
Dwelling (a)
Residential improvemenis
Garage (5) (
Other impmvemenis (6) ��
Total improvements (line 4 Ihiough line � (7)
Total value (line 3 p�s line 7� (g) I
I hereby Certify ihe above is Uue, correCL and Signamre of Assessor . Dare signetl
complete.
V=�+ying action - Syna;ure of Auditor Date signed
19_Pay79_
Lesser of 1/2 Homeslead
Valuation or $2,000
S
ALLOWANCE
SignaWreo�AUtlpqt _ � . 1 � (� � Ivaie
{��1. J l..l J � � y