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Homestead_Broshears SlAUE FORM stn.lR I fwd mFASURER FORM 75-IA VPRQ'm fly STATE RMRO IKM'IXR'.ia.!nw PRINCRIBED BY THE(EPAR/VE.0'F LOCAL CMnRW,FnT FINANCE R VI.1-24.1 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 or this deduction becomes Q_ more beneficial.there is more incentive than escr for homestead fraud.Ilomestead fraud causes higher tax bills for all:therefore. ® HEA 1341-2009 requires taxpayers who remise the homestead standard deduction to verify that they are eligible to recene the benefit and to provide additional identifying information nemsary to allow county government to better monitor homestead filings.This information will be kepi confidential and can only he accessed by authorised county officials.The Department of _- Local Government finance will use this information to create owls that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Broshears, Rodney/Jo Ann Broshears R3 13ox 309` sat 47639 10870 Rodney Van/Jo Ann Broshears 492E 1200 S State Parcel Number Legal Description HaubstadlIN 47639-8815 �r�rr��nt�t��nn��t�t�It�ui�t�n�nu��r�r�r�t�un�r��u�t� 26-23-07-400-000.177-024 004-00177-00 PT E SE 7410 1 A D-9 X Spouse First Middle /� n Last JO itV� 6rbSh.CQ ✓J' Mailing Address(Number and street,city,state,and ZIP code) as property address yqa C taco r4sEacQt 3x1 y -2 (37 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. • POPM HC 10 7979 PiescribeE By State BW�tl al ia. Commissioners CLAIM FOR HOMESTEAO PROPERTY TAX CREDIT FOR YEAR 192`� To Be Filen in Duplicate SEE BACK FO FI G INSTRUCTIONS � � �G �,(We) � certify that on the tst day of �harch, 19_� �, I, (We) I place of residence the followin described real property for which a Homestead Property Tax Credit is hereby being claimed: 1 / �3-07- d-�6d/7�-�S� I, (We) lYJ owned ❑ are buying under contract 4 D� �"' Q �/ 7�'" Qd ❑ have a beneficial interest i th`C�er Property Description in y County Township Taxing District (Gii� �ewn, Township): �-.a-� Parcel Number � � � �". � � or legal description shown on tax statement: Pt L-"a S� v 7' `/' /o /o-�,..� If buying Ofl contract Owners name ��ee simpie ownep Contract recorded in Recorders Office - Record No. Page If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of the property utilized to produce income Any other counties in which individual owns or is buying real property: � hereby certify the above statement is true, correct and complete. � �C�� �e.e� z3„���- % , �,�� ,�i�3�y 'Stgnature Sveet noeress . Counry Township Ci:y. Scaie and Lp Cooe Individual either owns or is buying under a contract that provides he is to pay the property taxes on the residence, or has a beneficial interest in the taxpayer. - FOR ASSESSOR'S USE ONLY - � � � � . True Cash Assessed Value Valuation Land not exceeding _(on� acre immediately surrounding residential improvement$ -, - (� ) .S a a / 7 0 Other Land •!��� ?' 1 �Qf� (2) — — Total Land Residential Improvem� � � Other Improvements ��welling A Garaqe Total Improvements - Line (6) plus (7) equals (8) qy ceriify the above is true. correct. and complete. , Sigiam� ot Assessor U Approved:— (3) .S o 0 (4) `�� /b (s) �7/0 cs� i a .s'a o (7 � �? !o n n (8) /.� /�70 ��.P■:��.�.�.� 0 Homestead Valuation � � �S-a/- 7 Da�e Date: —��/- 7 9