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Homestead_Tipton I '" MATE M10.153.!/.IBU•-N1 nnrASU.C%FORM ASIA .APPROVED BY SLSIEBIMRD OEMVnnNrS_uw PtrffiAIBm BYnlrorPARAe`ITrw LOCAL GOvERS'NR1t FBL56rE IC 6-I 144.1 1Gibson 1 Main County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 101 N Main PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes o more beneficial,there is more incentive than eter for homestead fraud.Homestead fraud causes higher tar bills for all;therefore. HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to receive the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filings.This information will be kept confidential and©n only he accessed by authorized county olTmiuls.The Depatnxnl 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 Properly Address _ Tipton, Mark D/Susan J — 1012 S Lincoln Fort Branch IN 47638 2968 Mark D/Susan J Tipton 1012 S Lincoln State Parcel Number Legal Description Fort Branch IN 47648-1724 26-19-19-103-000.790-02 011-00790-00 LOWES ADD 43P1/44 ltlttllt �t��ttt�tt��tt�ttrt���rrr�tt�t�t�tt�tt t��tt�t�t�tt�� tt 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 MArk nous /AS T.p �oN •ng Address(number and street,city,state,and ZIP code) © Same as property address /0/0 S, I—INCo/N Fort,-ArM d11 IN Li'7411g 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 _S 1 1 �1 fiC 10 1J79, ' To Fiz Fiied in Jupiic�te ;cribed By State Board of Tax C.oQmiissioners • ��, CLA1M FOR H(X`'ESTEAD PROPF3�TY TAX CRQIIT FOR YF1aR 19� �'''`� ?�/ rinci olace of residence the follv.uirig. descri.bed real operty or which a Hamstead ?ropesty Tax CYe3it is here�y being claim�l: (We) � owna3 . , � are buyina unier contract � have a beneficial intere�sQt� in the taxpayer .. . operty Description in ,(�,/.�e.ex_ CouLnt�y . Ta.mship xing District (City, To,�m, 'ItHmship) : .t - /� rcel tlianbes or 1��gal description shown on tax stateresit: p`�.tr-i...,x..',� a.,....L �_ `/ 3 s �i � � � buyina on �ntract: O.,mess nan�e (fee sirtQ�le owner) Contract recoxded in RE�rder's Office - Record No. Page ,_ any.portion of the residential structure or the lanci, not e�eeding one (1) acre that mediately sw.-roiuds that structure is used to produce incane, describe the use and portian oi e property utilized to pmduce income y other oounties in which irxiividual owns or is buying real property: � certi� above staterent is true, oorrect arrl conq�lete. County 'Ilhmship �,t. ,�.a�-,�� .1ZlL N• City, State Zip G Individual either owns or is buying �mer a oontract that piovides he is to pay the Property.taxes on the residence, or has a beneficial interest in the taxpayer. - FOR ASSESSOR�S USE ONLY - ' . Tn�e Cash Value ;id not exceeding 1(one) acre i�reciiately srow�3inq residential ii[g�rovarnnts . (1) � �1C'T Idild �Z) . . �tal Land sidential 7icQrov��ts her Lc�rovanents '; Lcq�rov�nents - Line (5) Plus •��by certify the above is true. �qnature of Assessor L�,aelling Garaae Zbtal (3) (4) (5) J 7 � �c�a�o (6) � $i'-1-o (7) � Assessed Valuation � �O . . �������/ ��������/ .• (7) �1e (B) (8) / �a�-fo � �ob° correct, arri orniPlete. - - ACTION BY ?UDiT�R - � Dat,e iianestead Valuation � [�S O . /��������� /�������� 7� G�-�- __ . �__-��-. -� . � , � y 8 �