Homestead_Adler (7) • • SLATE FORM.1WIle t 4N1 TPF4Sn[Ea FORM ta-IA
1FFN(■'En BY,tATEa 1 OOf MIYTR%T&!OV •RJSCRIBFD BY TIF DE?MTMEMrtF LOCAL 1-0Vsentrwr FINANCE 1041.1-224 I
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 eser for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• ILEA 1384-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reccise the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept conlidemial and can only he accessed by amhorimd rnnnly onicinls.The Depannrent of
Local Government Finance will use this information to create tools that will help county officials eliminate hurncstcad fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Adler, Cynthia/Jeffrey
RI Box 350 I) {,
Ilaubstadt IN 47639 /T
9564 �/
•
Cynthia/Jeffrey Adler U/
2231 Wa1200 S State Parcel Number Leila,Description
Haubstadt IN 47639-8736
I IIIuIIurllI'llrllll I ulllllln'InnllnnllD llrl 26-22-14-100-000.007-024 00044-00007-00 E NW 14411 1 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
R Robz
_
1Qr-
tg Address(number and street city,State,and ZIP code) - - --- ❑ Same as properiv address — — -- °
aa43� /too $ s sear 2(76 39
;'�
Spouse First Middle /1 I Last
`R
Ft
Mailing Address(Number and sweet,city,state,and ZIP codes){ Same as propene address
2a 3 � c�-c gAuesrf}DT N Le-7c,37
Each undersigned certifies,under penalty of perjury.that the above and foregoing information is true and correct and that he or she is eliuible 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
•
Z,'-�ir�e) (J�-sLC,C-�
P'�rch, 19_, I, (We
.��oerty ior wnich a
�Y]J.LL Vl 16d W1l\ILLDDLVIIGL.7 . . .
CLAIh1 FOR HOh'ESTEAD PROPERTY TAX CRQ)IT FOR YEAR 19_ . 3�' -� �
SEE BACK FOR FILIN6 INSTRUCTIONS
'�-`a- ��"`�l r"��..� � D�� Om0 y� ��day of
as princi,oal olace of residence the follaaing des¢ibed real
?roperty Tax dredit is he�eby being claime3:
1, (Yae ) ❑ v,ansi
� are buyinq urrler contract
� have a beneficial interes
ProDerty Description. in �
Taxing District (City, Tw�n, 7bwnship) :
��-��-/�1�-�-a�� ���
in the ta�mayer
•• i ,
RbwR15tLLD
n�A1 ;�s or l�gal description shown on tax statanent:
ly',�. E �a n./ LcJ �i� � �f - `f - /! / Q�.
If buvina om m�tract: Owners name (fee si�le owner)
Contract re..rorded in i��rder's Office - Recnrd No. Page
If any portion of the residential structure or the land, nat e�eeding one (1) acre that
ism�erliately sun.row�ds that structise is use3 tn produce incane, describe the use and partion of
the property utilized to produce.income
Pny otl�er mimties in which individual owns or is buying real property:
I herehy ce.rtify the above statanent is true, o�rrect ard co�lete.
�.�
Cotm 4bwnship
ucy.
'Individual either aans or is buying tmer a�ntract that provides he is tn gay the
oroperty taxes on the residence, or has a beneficial intenest in the ta�q�ayer.
- FOR ASSESSOR�S USE ONLY -
True Cash
Value
Iand not exoeeding 1{one) acre inmiediately
sisrourziing residential i�zovanents (1) .�mo
• - . ..
Total Land
Pesidential Inpxoveirp-nts
Qtl1=r Irtrorovanents
Dwelling
Garaae
4bta1
(2)
(3)
(4)
(5)
(6) 3 I � �
��)
Te Imozove�rents - Line (6) Plus (7) �xuals (B) (8)
I heseby certify the above is true, correct, and ornmlete.
- ACTION BY AUDITnR -
1�oroved: Date:
Assessed ilanestead
Valuation Valuation
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Dat.e
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