Homestead_Adamson (8) SLIME FORM!3,a•OCI NNI mRFASURFIl FOAM TI-IA
.VPRxEDDY pRL ROSRO rw.YSwksn.ary PRFYTJPM BY THE M ARTY£Y=OF L(:0.IXra/CIMPFr MANCEW Hti'al
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 becomes
more beneficial.there is more incentive than ever for homestead fraud.I lomestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify Out they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county goverment to better monitor homestead
tilittf.,.Ibis information will he Let ronfdmiial and can only he accessed by authorized d county officials.The Department of
I.ocal Government Finance will use this information to create nods that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Adamson, Christopher RiRachel M
Schmitt
704 N Main
Fort Branch IN 47648
7169
Christopher R Adamson
4156 W 1000 S State Parcel Number Leal Description
FORT BRANCH IN 47648-8159
26-18-33-300-002.272-024 004-02272-00 PT SW 333113.84 AC
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PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
eitnc S\D?hc-li av \ - Pc .r A�
rg Address(number and street.city,state,and ZIP code) - - — Same as properly address — -- - -
41 Sb to 1000 S // F'+-: 4 rareh IM tlf(pc $
Spouse First Middle Last
t- 011V e,l Miajalk ��rM, aMynn
Address IN
1
Mailing Add (Number and street,city,state.and ZIP code) D Same as property address
L11 Cif W IOOO S , ff
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 1 Signature Date
•
:�'`r�"`��:•
�,; -`���
�y
CLA1M FOR HOMESTEAD PROPERTY TAX
CREDfT/STANDARD DEDUCTION ^'
smm r� ure ca» so� �� �T'
Presabetl by Ihe O�epatr'art of Laol Gorermad Femice ��
INSTRUCTIONS: See revarse side /or filing in�ns.
•�.•r: �.,.. `;..�:;.':.'. �
FORM �R
HC10
I(We) / gi'�t on 1st day oi M , ZO_
I(We) ocapied as aa prmd pta�e�o! resider�ce the� real popeAy far which a Hm�esMad Propaty�'r�y daimed:
,n'\(�)� ❑ �b�W�9��g�� GIBSON COUNTY AUDITOR
;ave a bercfitial citerest m the enfily Ihat is liade br Me propaty �ces on Me popaly arW tl�at owns the property or is Gryug urMer a contract
'St"i+f J .:Y �� s� i�.� y, �-5. fi .-'h�: F.� 8 �i tyu.� } 4 a �� � is,� ii '^ti � tRl� x�3`
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Y
rc buyrg a, m�tr-ea. Fea Sin�le n.nefa ren,a _
I�udefn oRm where m�haci is recaded �- " Recad num6er Pega
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TownsHp
6�wn.
Pa�ml romiber Legal la Me paparty n question:
rt8-33•300-L�b2a'!d• a4�-E�S�33=3-11-�_.. � ❑�,�,, ❑ �b�,o.�.6,.,_n
tl an,,,ortion aitha raside� sh„rL.e v Me lantl nal m¢ee�rg one („ eue tlut n,me�l„ wrtm� tl� ffiu�ae is �sad b qodm nmma. das�e Me �ne entl ,ortion
d�°`°°�""�°m"°��",�,�°. . 3,84" 19c:
.' r ASSFSSOR USE ONLY �`' � �it't+�i : � �.�7RUE.TAX A� WLLUE �I�STEAD� �. ��. �}NONiCESm6tilAl'�"}s��
�t.,�",� c Y'_-'J�,�. ;:�,.� u �.. :'r�t�t�.�Li;�t2�VALUEh � >AT100X�OsFTTV,�.f.'a„�..iVALUE..t'.>x..i>.�",.a�Yi;n..'a.:Va-�r;�t°°,�.ui���.tf::
Land not e�ee6ng 7(one) acre irmiediiffiely '.ni 5�rj� ,-:'�{ q,�,�S°r 3r*� f:,
t
Siufoundlrg fesidential irtlprovements. �� � �� fi+"`� �� �?: �„'�`4�,. ra':.Yr � b'��lia�±
i
�19f �2/1d ' � `
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Td� land (liie 1 pkrs Gre � �g)
� ��niff: �a P. x Fyh+,'( •5 � �i'_�
ReSidentiel'vnprovenenlsaMrwafly ��� �4� Y '�%r�'S�.��,'��t,t�'i�`u�.'F�4"��4i�
Aaessed Alebde / Mamtfat4ied Florne �� 5 ': •�n`�f� �}'}�`�a�%�h� ' i ? �4 �rti'
( ) �' � �����w,=',rxl?3��h^�?�,,"�e�`:^ti
Otl�e�t unprovert�enrs (6) 7 ';.ir � ; `r,:
a
Tdal "vrryrovemenls (�are 4 WougA 6ne 6) �7�
Tital vatue (1'c�e 3 pps !me � �g)
I hereby certify the above is We. carect. and ser�amae of nsasvor oare signm
�
vairyvg atflan - Sipimme othidfv Oem sig�ed
20 _ Pay 20 _
Lesser of 12 HomeSead
vauatian w S35,o00
si�ue of Aud�mr
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