Homestead_Burns STATE FORM 53Mt,R /)•NO MPEASUELRPo0.VSIA
APPROVED BY SLUE BMW OF AraCNl t.:US PRFs,ml'DMY}n[OEPARTME.t(FMCA'GOVERNMMT FINANCE M 41.1-L'-!.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to ore homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than eta for homestead fraud I Iomestead fraud causes higher tax bills for all:therefore.
HEA 1344-2000 requites taxpayers who receive the homestead standard deduction to verify that they are eligible to receve the
benefit and to provide additional identifying information necrsmlv to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be acre.sed by authorized 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
Bums, Donald L/Jo A , IWI
RI Box 128 A IR-i
Haubstadt IN 47639 01.
2675 gx11
Prior I+-D �c.
Donald L Bums Re4dakre-SS I ng 0
R1Box 780 State Parcel Number Legal Description
HAUBSTADT IN 47639-8622 _
26-18-36-300-002.023-024 004-02023-00 HUNTERS CROSSING 2
t o to r nu t t n u n tut t n t n n ton LOT 91
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
Do,tJALc) SEC & URNS
lig Address(number and street.city,state,and ZIP code) [] Same as property address
Io 3' : 5 ; QUAIL CRossi/uG , HAoB.7-A DT„ /'l Li763Ct
Spouse First Middle Last
o 41-1/a '3 U ("5
Mailing Address(Number and street,city,stale.and ZIP code) Same as property address
/023( SO 4E4 Quail CvossiwA (-[ztuk5-adf /'(� 41639
---- --�_--
Each undersigned certifies,under penalty of perjuy,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 Signature Date.
CLAIM FOR HOMESTEAO PROPERTY TAX
- " CREDIT/STANDARD DEDUCTION
� � Shale Farm 5473 (RS / 10-01)
��N Praaibed by �ha Departme�ri d Local Govemment Finance
INSTRUCTIONS: See reverse side /or filing instrucfions.
FORM
HC70
���
YEAR
� M�e) � � certify tha n the 1st day of�FilarcX�'1ti_
I(We) occupied as our prindpal place of residence the ollowing descnbed real property for which a Homestead Pr rty Tmc Credi �is heieby daimed:
❑ I(We) owned ❑ Are buyirg under contwct " C�BSON CpL�,�%��
T'� qun,r
�Have a benefidal interest in the entity Nat is liable far ihe propetty taxes on the property and that owns the property or is buying undar a conGaU.,
If buying on conVaG. Fee Simpie ownefs name
Recorders ofim whwa contraq is recorded
a`�'.��'�-��°��.i'�'�`+3�i`x
Caunty � Tnvnslup
�v'1 ' C!�t�oZ•s �f,sa.
H any poRion of Me resitlential shucWre w tlie
o( the property Wl'¢ed b produce income.
Taing disUicl (dry, fown, (ownship)
end not excee0inp one (1 � aae Nat im� ;
- G ��� — �/�i _ KY7l.� �
Record number � Page
Is the D�P�Y in question:
❑ Real propeM1y ❑ Mobile Homo (I.Q 61.1•� .
iunds that sW cNre Is used b produce Noome, desm'De Uie um arM portbn
U
20 _ Pay 20 _
Lesser ol if2 Homestead
Valuadon or $6,000
S
Data sicyred^
