Homestead_Stephens MATE FORM'O IR2r 5.7,0 WARMER PORN SIA
.APPROVED BY MATE WINO OF.ACIYa'L'1s,Y.ry PAEYt121IIQIBYIlE OFPARneEVr(F LOCAL CAVE...VMFAT FINANCE IC bI.I-r-n
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 tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to creche the
benefit and to provide additional identifying information necesn,ry to allow county government to better monitor homestead
filings.This information will he kept confidential and can only he accessed by authorized county officials.The Depanntent 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
Stephens, Lisa
603 S Main
_ Fort Branch IN 47648
2588
Lisa Stephens
603 S Main State Parcel Number Leoal Description
FORT BRANCH IN 47648-1725
liluilliiiltlltttlltllltlrttrlllrttlt tlrlt lrlrll Il rr tl lit 26-18-24-202-000.290-02V V 011-00290-00 MCCRARY ETAL 100 PT
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
line Address(number and street.city,state,and ZIP code) fat Same as property address
Spouse Os— First Middle Last
4.
Mailing Address(Number and street,city,state,and ZIP code) 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)
se=
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
•
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PART 4:ADDITIONAL INFORMATION
,�_.
e��"TM'. CLAIM FOR HOMESTEAD PROPERTY TAX }
_� .
CREDIT/STANDARD DEDUCTION
I ��y�, • State form Sa73 (R2 / 5-92)
• `:\� 7;���:
,e�. .
INSTRUCTIONS: See reve�se side tor liling instructions .
FORM YEAR
HC10
I(We � � . certif Ht�t o0ih�75t f ta . 79
�
�:) occupied s our principal place ot residen e ihe following described real property for which a Homestead Property TaxJCI i s y Gaimed:
v I(We) owned ❑ Are buying under coniract . �UL �. 6 1997 '
❑ Have a beneficial inierest in ihe emiry ihat is liable for the property taxes on ihe property and that owns tF}G property or�is b�uy[yig under a contract.
. . �' �i .'—_�i rn� ��
If buying on coniract, Pee Simple owner's name
Remrdefs oflice where conlraci is recorded
. •� CONTRACT
PROPERTY DESCRIP'fION
Caun,y � . Township � � .
Parcel number L al � n
v l/ -t�va90 - c
If any ponion ot ihe residential stmcwre or the land not exceeding one (1) acre that
of the property utilized to protluce inmme.
Recortl number � Page
that structure is use¢to produce income, descnbe Ihe use antl portion
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County TownShip Counry TownShip
�eby certify the above statements are ime, correci and complete. S. na� e of Gaimant
Address (numberandstreet. city, sta(e. ZlPwde)
� ���g
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
� VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvemenis. (�)
Oiherland (p) � '
Total land (line 7 plus line Z� (3)
Dwelling (4) �
Residential improvements
Garage (5)
Other improvements (6)
Total impmvements (line 4 fhrough lina � (7)
Total value (line 3 p�s line 7� (g)
I hereby Certify ihe abo�e i5 �me. CArreCi. and Sgnature of Assesmr Da:e signed
complete.
Verifying action - Synawre of Audiror Date signed
�
STANDARD DEDUCTION ALLOWANCE '��
79_Pay79_ �i
Lesser of 7/2 Homestead
Valuation or 52.000 S
Sign ture f Auditor Date s�ed /�
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