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Homestead_Besing ■ SLOE FORM•F'•IR_'/•+v1 IREASURFR FORM 71-IA APPROVED nyMATE BMROOFvvv*.T•.ao. PArxtUmmM THE BFPMTIGYT OFts ALnHCRYMTNT FINANCE B'.-LI-1'-!t Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and hurried couples are limited to one homestead standard dduction.As the receipt 01'this deduction becomes _ more beneficial,there is more incentive than eser for homestead fraud.Homestead fraud causes higher'as bills for all:therefore. • DEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verily chat they are eligible to receive the benefit and to provide additional identifying infomlauon necessary to allow county government to better monitor homestead filings.This information will he kept confidential and can only he accessed by authorized county officials.The Dcpannent 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 R 2 Box 33 Haubstadt IN 4763 8377 State Parcel Number Legal Description Haubstadt IN 47639-7828 1 I I I III 11 1 1 I I I I I I I I III I I 26-19-35-200-000.079-024 004-00079-00 PT E NE 35 3 10 27.19 AC t o nt r nn t t et nt a ru c ei n nrr r ru D-10 . 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. } CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION / S�ate Fwm 5473 (R6 / 1-03J Prescribed by the Department W Local Govemment Finance property and Ihat owns the property or is b3ying �rYd�Ya contract. If buy'viq on conVad, Fee Simple ownefs name Remrders olfice where conirad County Tamship n}��'(��= ,f�/� /1' )(? n j� Legal descripGon J �� �" V \.% � 7���./ � If any poRion of Ihe residen�lal sW Uure w Ne land nd exteeding one (1 J aae ihat ot fhe Droperty utilaed tn produce income. -/9-_3s ��ro- County I hereby certify the above statements are We, corred and mmplete. and sheef,y�ty, stafe. ZlPcode) Land not exceeding 1(one) acre immediatety surrounding residential improvements. Other land Tdai land (line 1 plus line 2) Dwelling Residenfial Improvements or MnuaOy Asse�ed Mobib / Mami(acNred Home Garage Other improvements Tdal improvements Qine 4 fhrough line 6) Total value (line 3 plus line � I hereby certify the above is W e, coned, and complele. Verifying adion - Sig�ture ofluidiWr (�) l2) (3) (4) (5) (6) I�) IB) SignaNre of Assessor Record number � Page praperryin question: �Real property ❑ Mobile Homo (I.C. 67.7-n that SWQUre is usetl to produca income, desaibe the uu and portion � ol claimant Date si9ned Date signed