Homestead_Stephens (2)CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19
SEP,BAC� FOJ�FILING INSTRUCTIONS /00/-0/0 -Z2-00
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I, (We) certify that on the 1st day of
M 19 n I, (We) occupi our prin pal place residence the following described real property for
wl. a�H/ommestead Property Tax Credit is hereby being claimed:
I, (We) 64 owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Properly Description in County_ Township
Taxing District (City, Town, Township): ' ^�
Parcel Number_ or.Iegal description shown on lax statement:
PL w(ia ID-3-7 1-5-DO AL
If buying o L t recorded pee simple owned
t recorded in Recorders Office - Record No. Page
If any portion �Q�^t a gsi stial structure or the land, not exceeding one (1) acre that immediately surrounds that
structure is UNY440( eft 99 income, describe the use and portion of the property utilized to produce income
AI Intrno
Any other counties in which individual owns or is buying real property: County Township
hereby certify the above statement is true, correct and complete.
kx-)-U-�tt
'Signatureearess _. City. S a Zip Cod
Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
FOR ASSESSOR'S USE ONLY -
True Cash
Value
Land not exceeding 1 (one) acre immediately (1)
surrounding residential improvements
Other Land (2)
Total Land (3)
Residential Improvements Dwelling (4)
Garage - (5)
Total (6)
Other Improvements (7)
Total Improvements - Line (6) plus (7) equals (8) (8)
I hee certify the above is true. correct, and complete.
Signature of assessor
- ACTION BY AUDITOR -
Approved: w v v ,
Assessed
Valuation
Date
Homestead
Valuation
MIME
Date: ` "
;- STATE fO?M 5nt IR:/''I TRFANIIR FORM TS-IA
AMMO BY Stilt 1MRD CIF ACO '.,T&_%D PluYRIBED BY ME oEPARTIEYTCft[RME G VtL'OOtT MACE IC 4-1.S-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 saodzrtl 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 1344-2000 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying informaton necessary to allow county government to better monitor homestead
filings.This information will be Ley confidential and can only be accessed by authorized county officials, it Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead tmud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Stephens, Everett L/Kimberly D
RI Box 174 D
Oakland City IN 47660
254
Everett L/Kimberly D Stephens
R1 Box 174 D State Parcel Number Legal Description
Oakland City IN 47660-8578
1t1u11ut1Pllu till iii r1u 1u 1r1r1ntilu ltltintiiii 1 it� 26-20-10-200-001023-001 D�1-0t023f10NNE 10-3-9 t5 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 ,
Owner I First Middle Last •
A:ver.e. _ I Sit",1 L�
iong Address(number and street.city,state,and ZIP code) ❑ Same as property address
9n9
�- `�
Spouse
/) First Middle Last
Mailing Address(Nu r �] /J and street,city,state,and ZIP code) Same as property address
9095 55o • r/ y7ie�
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