Homestead_Andrews stall FORM,3'.NI R:J. t TZLSUtER FORM:}IA
NITICOVED BY STATE WNW OfY IR!NTs._nM PRFSRtBmal'nit OEPAR-Da Of 1.(X:AIGEWEILNNIENT F*:AYCE MLI.1-•'4.1
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 ester for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
• HEA 1544-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and lu provide additional identifying information necessary to allow county government to better monitor homestead
tiling,lobs information will he kept confidential and can only be accessed by authorized county officials.The Depanmsent 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
Andrews, Aaron UNatalie L
R2 Box 149 M n`-'
Ilaubstadt IN 47639 O�`
3481
Aaron L Andrews
2728 E Warrenton Rd State Parcel Number Legal Description
HAUBSTADT IN 47639
26-23-15-300-001.757-024 004-01757-00 PT SE SW 154101.00 AC
X
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
A-atm Linn Air& wS
Ong Address(number and street,city,state,and ZIP code) [J Same as property address
71-1S1 , WelYt-e ' -1 m IQ-oJ ) * t&-V I IN 4rl(oV1
Spouse First Middle Last
140A-Ot Lunn ActiatAils►
Social Security Number(last 5 digits) Drixri s License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
9571 5�n_IN 512(9
• 4 • 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 .. a Date
•
° CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
` � ` Stafe Fortn Sd73 (R8/7-07)
Prescribed by Ihe Department of Local Govemment Finance
lNS7RUCTlONS: See reverse side /or fi/ing instruc6ons.
, �
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-
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AUV 1 2��8
� e �i�oY � 7��e: �' a � ,��
(w ) certifytha�g�i �e�q�11��1a,$Ub�T�
1 e oxu 'ed as our "
(W ) p prindpal place of residence the fWlowing described real properly fw which a Homestead Property T�c Creri is ere y ai
�'�(VJe) owned ❑ Me buying under oontract
Have a benefiaal interest in the entily ihat is liable fw �he property tazes on the property and that owns the property or is buying under a contraa.
If Wy'v�g on canlraq, Fee Simple ownels name
Recordefs oifice where cmt2a is retorded
County Twnship
town.
Record number � Page
Pa� number Legal tlescCnption � ) /•U//C Is �he property in question:
S` ,�(,ti �•s v�!� ❑ Real property ❑ Mabile Fbme (IC 67.1-n
If arry poriion o1 �he residential swclure w ihe land nol erzcaedirg orre (7) acre ihat immediately wrtounds that sVUCture is used to pioduca inwme, describe Ure use ard porUon
af Ihe property u6Gied tn praduce inoome.
�G -o?3_/S_3oo - oo� �5�-�a4�
,
.- .
. . .. . ,
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Land nol ez�ng 1(orre) aae immediatety '�" -- �
surtounding residential improvements. ��� . , ' i` �` . ' - �
OtherlarM �Z� -'" .;';`;�,
Tdal land (line 1 plus line 2) �g�
� � : _
Dwellifg (4) r '
Residential improvements or Mnually
Assessed Mobile I Manufac4ired Home ::i j �:;.` �
Ga2ge (5) - . .
- _:�:...�:.... -
Other improvements �6� . . F1T � . . �
T�al improvements (Gne 4 through Gne 6) �7�
TUaI value (line 3 phs Grre n (g�
I hereby certity the above is We. cortect. ard siqnawra otwssessor Dale signed (mmth. daY• Y��)
complete.
VaiAi^B acUm - SignaWre of Autlitor Date signed (mmlh. daY Y��I
�.-� � � � •
ZO pay 20 _ qg.ppp for 2007 pay 2008 42.000 for 2070 pay 2071
Lesser of 12 qq.000 for 2008
Homestead Valuatim P�Y 2009 4�•D00 �or 2011 pay 2012 $
« 43,000 for 2009 pay 2010 40,000 payable after 2012
Signatura of Audlta Da�e si9ned (mmN, day, yea�