Homestead_Zeabart a , x1ATE FORM!Mt*tIC I sc.) rM NIfII FORM 71IA
AP/ROVED FIT MATE DRUM Of AMII■y'T5.5m PRIVLPmm1Y tilt DFPA0.n T(F L0.AL row:R`!w'Jln FKU'cERVI.1_-ll
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 besoales
more beneficial,there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
• HE.\ 1343-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to mcene the
benefit and to pnn'idc additional identifying information nnrsmy to allow county government to better monitor homestead
filings.This information will he kepi contidenlial and can only he accessed by authorized county officials.The 1)epanment of
Local Govenlment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LXFORMATION
Taxpayer Name Property Address
_ Zeabart, Karen S
803 Mohawk DR
Fort Branch IN 47648
7605
Karen S Zeabart
803 Mohawk Dr State Parcel Number Legal Description
Fort Branch IN 47648-9536
II III I II III I I II I I II
111111181 26-19-18-101-000.999- 011-00999-00 LITTLE YORK VILLAGE
I tl tll I try rr rr r 1 rrr t Ilr It II 11PT/12/13PT PHASE 1
�/
Spotue First Middle ,, _ // Last
Fen) su � �� T
Mailing Address(Number and street,city,state,and ZIP code) Same as property addles
-- _
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 elieible 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.
_' _
� � v�q . . � . .
! a CLAIM FOR HOMESTEAD PROPERTY TAX
I �;���; CREDIT/STANDARD DEDUCTION
�`�• State Porm Sd73 (R2 / 5-92)
�eu
INSTRUCTIONS: See reverse side !or 7iling instructions.
� � � - . . ,. �CERTIFICATION STA
FORM _ YEAR
HC10 � ,
certify that on ihe 7si day of March, 79��
� place of re 'de e the following described real propeny for which a Homesiead Property Tax Credit is hereby daimed:
I(We) owned ❑ Are buying under contract . �' �
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and thai owns ihe.property or i�y�+� er�p�y�
� . � • . ' . � . . . �7 � N'i _�
- CONTRACTRECORDED . -
It buying on con[racL Fee Simple owner's name . � _ _
Recortler's oNice where contrect is recortled Recortl w r_ __,,l} F���ir�
Counry � Townsttip.
Par I mb ' QO Legal tles
J
It any portion oi ihe resitlentlal strucmre or the IarW not i
of the pmperry utilizetl m protluce income.
PROPERTY DESCRI
Tazirg
(l�acre lhat
�
�
is
� ' PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Couniy TownShip County
�a
\ Signature oi Gaim
e�t_� certify ihe above statements are true, correct and complete.
Address (numberandstreef. ary, sfare, ZlPmde)
mn� _. ! . � o �. o l _.. .......���.
, ASSESSOR USE ONLY
Land not exceeding 7(one) acre immediately
surrounding resideniial improvements.
Oiherland
Total land (line 1 plus line Z�
Dwelling
Residential improvements
Garage
Other improvemenis
Tmal improvements Qine 4 through line �
Total value (line 3 p�s line �
I hereby certify ihe above is true, correct, and
19_Pay19_
Lesser of 1l2 Homestead
Valuatlon or 52.000
TRUE TAX
VALUE
(�)
(2)
(3)
(4)
(5)
(6)
l�)
Iel
of Assessor
ASSESSED I HOMESTEAD
VALUE VALUE
STANDARD DEDUCTION
�
S
�a� �z r3�/
iesc be the uge aM portion
NON•RESIDENTIAL.
VALUE
Date signed
Date signed
Date sWaed i/ ] �