Homestead_Williams (11) MATE I. tICly I TREANrIR FORM 3-IA
.A fRIT'EO BY MATE[NW DM AM-PUNTS.!MN PRISRIBm BY PIE DEPARTMENT OF UAW-rAm RYMEKT EM'ANCErC VI.I-r4.l
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sundanl deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than exer 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 remise the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.ibis information will he kept confidential and can only he accessed by authorized county officials.The Depanment 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
Williams, Stephen R/Wendy J as 3 -1 q SE
.ftl Diz.a 19: \\p
Fort Hmnch IN 47648 V
3031
Stephen Williams
293 E 795 S State Parcel Number Legal Description
Fort Branch IN 47648-8008
II ' II III I I III I I I I � ' II III 26-19-19-204-001.324-02 007-00717-00 INDIAN HILLS 93
ru nr r nrn n rot nr rout r tau rn r D-27
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
S
ktaken re._-- \i\-) I LI I Clr--S
Ong Address(number and street.city,state,and ZIP code) ®')Same as property address
Spouse First Middle Last
WendAI J 11.) t 1llams
Mailing Address(Number and street,city,state,and ZIP code) [' Same as property address
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
•
CLAIM FOR HOMESTEAD PROPERTY TAX FoRM YEAR
} CREDIT/STANDARD DEDUCTION HCto
i Sute Fwm 5473 (R6 /1-03)
Presaihed by lhe Department ol Local Gavemment Finance .
INSTRUCTIONS: See reversc side lor Iiling insfmclfons. I�� j� �� {L ,� [; �
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�.��`"��r3`�"c3at —'- . -, °- �r�'"..;:.• °- `�.• �a:"-.CERTIFICA710NSTAlEME - r-�-' c �.-�a �s..er "
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�(We) ertify that on the 1� l�day of M�20_
II(We) occupied as our rincipal piace o( residence the following describ real operty for which a Homestead Projerty T�c Cred� is he�eby dai/m�ed:
, ❑ 1 (We) owned ❑ Are buying under wniract 'n�,c,�J ! i . . !/ .�
it�lA�71.iL�'
a Have a benefiaal interest in lhe enGty that is liable for the property taxes on the property and that owns the property oi s baying under a iontiaU.
I( buyinq on contrad, Fee Simple owners name
Remrders ofice where conVad is remrded
Tamship
�aga� Ce:
tl any poAion of Ihe r8sidenLal sWcture w the land not exceeEing ona (1) acre Iha�
of the property utilized to produce inmme.
�/% �� / �
Record number � Page
Is the pmperty in quesUon: /
� � Real proparry ❑ blobila HOmo (I.C. 67.1-n
wrrounds Nat siructure is used to produce income, describe Ihe use and portion