Homestead_Brown (2) STATE Mica!!"0,11C/ TPFA91{r$FORM ia-IA
♦PPWW'EDBT MAT,.enkIRDOF Arvva,vn.AAA PLFSAITFD BY Mt IMPARTMENT OF LOAM nos ssln.'r FINANCE IC VI.Ir-LI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 IndividuaLs and married couples are limited to one homestead aandard deduction.As the receipt of this deducion becomes
more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tar bills for all:therefore.
• HEA 1 344-$gW requires taxpayers who receive the homestead standard deduction to verify that they are elieibe to teethe the
benefit and to provide additional identifying nformaton necessary to allow county government to better monitor homestead
filing_This information will he kepi cnnlidential and can only be accessed by authorioed county officials.The Department 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
Brown, John W/Janet L
R2 I3ox 187 A
Haubstadt IN 47639
10879
John W Brown
1165 E SR 68 State Parcel Number Legal Description
HAUBSTADT IN 47639
26-23-08-200-000.829-024 004-00829-00 PT NW NE 8-4-10.616 AC
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PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
rg Address(number and street,city,state,and ZIP code) - - - — -'' // — 4Fne as property address - - — -- `-
//6 ,T S,47,er /1 1 CIAv,es bT /4 f 10 S9
Spouse -- First Middle Last
/��3NE7 Bea of/`i
Mailing Address(Number and street city.state,and ZIP code) ❑ Same as property address
//d t SM7E /rD G /9/40/327nD7 /A �7a,3 °;
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 t Signal 1' Date
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� Stata Farm 5173 (R6 / 4-03)
� Prcwibed by the Departrnen� of Lxal Govemment Finance
INSTRUCTIONS: See ieverse side /orWrig instrucfions.
,
FORM �� YEAR _
HC10 I I
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-.__-,y..,..,-._.n - .... <..�T<<,+F�-.:�- .�u..._.� �...�. �...,��.,� .,� ����.� � -
��e1 certiry that o�B ��t �ay'oQ IGfarch. 20_
I(We) occupied as our p- cipal place of residence the Ilowing described real property for which a Homestead Property T�c Credit is hereby daimed:
❑ 1 (VJe) owned ❑ !ve buying under contract ✓��5� � �
!� Cl
Have a benefidal interesl in the entiry that is liable for the property taxes on the property and that owns ih�� osGslF3ijr1§ybt�tf�EAntract.
If byvg on conUaq, Fee Simple owners name
Counry
conUad is recordeE
•F Kt�'a
�r��,' : �..:'{i���`x'�.'"w.m_r:_"��.�£-:
Tavnship
�n/< ,
a�
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Tating EiStricl (city, town,
Is ihe
Rewrd number � Page
❑ Mobile Homo (/.Q 67J-7)
If any portion ot Ne residen9al sWqure or Ue land not exceeCing one (1 � acre that immetliatety sunounds Nat sWGUre is used to produce income, describe Ne use antl poNon
ot the property utilized to produce income.
�Pa.�.P#a�- a3-�-a�,-c�.8a9-�a�
County
Twvnship
I hereby certify the above statements are We, correct and complete.
(number and streef, city,
Toxnship
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