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;a) pied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby daimed:
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buying on contract, Fee Simple owner's name
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Legal description Is
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the property in c !u!V-
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i (any portim of the residential structure or the land not it rWdia* sZiffolunds itialF structure is used to produce income, describe the use and portion
of the property utilized to produce Income.
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I hereby certify the above statements are true!-c-- -- -j",-
orrect and complete. I
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jjRUE-TAX
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ASSESSED.VALW .
ON-1
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Mmymijm,
band not exceeding 1 (one) acre immediately
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surrounding residential improvements.
(1)
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Otherland
(2)
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Total land (fine I plus line 2)
(3)
Dwelling
(4)
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Residential Improvements or Annuagy
Assessed Mobile I Manufactured Home
Garage
(5)
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Other improvements
(6)
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91S.11
Total improvements (line 4 through line 6)
(7)
Trial value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20 _
Lesser of 1t2 Homestead
Vauatlo4or 535.000 /-\ (-\ $
of Auditor
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CAFE FORM MY!MIR'l+wl TFB&S CR FORM 31st
APPROVED BY C1TE aMRDOF Art.TRtNI,.Y,. PRFSAInm BY TIM DFPARTQ:Yet:'LOCAL rAT'_RVMrh7 FP'A\TE It'61.Iv'-tl
Gibson County Auditor
X01 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couplet 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 has bills for all:therefore.
®
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are clicible to recent the
benefit and to provide additional identifyine information necessary to allow county government to better monitor hontsead
filings.11th information will he kept confidential and can only be 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 k PROPERTY INFORMATION
Taxpayer Name Property Address
Williams, Michael/Teresa 1
RI Box 16113
Oakland City IN 47660
8569
Michael Williams
5546 S 1000E State Parcel Number Legal Description
OAKLAND CITY IN 47660-8558
I I II III II II I I I I I I I I I I II III 26-20-11-100-000.974-001 001-00974-00 PT NW 11-3-9.5211 AC
to tart fit a utnntntrnnur X D-8
PART 2: TAXPAYER INFORMATION
Owner 1 First Middle l' I 9e = Last
• (A_, ..e.�Gf ono
long Address(number and street.city,sate,and ZIP code) • -- - - — fJ Same as property address - - - '-i' - _
6E2/6 J, /000 E 0' .ta' ,cin 6 6 O
Spouse First Middle Last
Jet IAJ�co
Mailing Address(Number and greet,city.state.and ZIP code) Same as property addras
SSW61. /000 E. (9/4 davite F1 4l7GGo
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
ll �� Date
PART 4:ADDITIONAL INFORMATION •