Homestead_Champion snit rnlM.lw 1R2 I,d t IREASUa0 FOXY 73-IA
•PPWWEO DY hill 110,110(14 N Cal'INfl.yrr PAEYAIRLDfY 111r DEPAAIhNT(*LOCAL GOVERNMENT FINANCE It"11-1.1-22-$.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 sundand deduction.As the receipt of this deduction becomes
mare beneficial.there is more incentive than eser for homestead fraud_Homestead fraud causes higher tax bills for all:therefore.
• HEA 1347-3609 requires taxpayers who receive the homestead standard deduction to verify that they ate ehicible to receive the
benefit and to provide additional identifying. information necessary to allow county government to better monitor homestead
filings.This information will he kepi confidential and ran only he accessed by authorised county officials.The Depanmmnt of
Local Government Finance will the this information to create tools that will help county officials eliminate homestead Baud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Champion, Thomas/Veronica
�
itT R 1130X 386 G
U flauMmdt IN 17639
11031 5b 1
Thomas/Veronica Champion
2078 Presley State Parcel Number Legal Description
Haubstadt IN 47639-7969
26-23-16-200-001.884-024 004-01884-00 COUNTRY AYRE ESTATES
111.111111111111.1111111111111111111111111ilielmillitlitItlel
20 D-9
PART 2: TAXPAYER INFORMATION r
Owner I First \1 Middle Last
�� C�/� 1aS ✓�seP Gin (3I0f. TI
gAddress(number and street,city,state,and ZIP code)— - - — — Same as property oadress — - --—'
o( i(). 7 3 pr eSIcA.4 PaubS-iwbi- 1n H7G3q
Spouse First Middle Last
Vero n . CcA CI
'` cx.Mrl(Y‘
Mailing Address(Number and street,city,state,and ZIP code) I-hEtute as property address
a D 7? flies ley ��,4 6s+0x.-1 ,rues 3ct
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 Signature Date
•
i�E ST�SF O
i�
yi.�.
r•�,
e
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION -
State Fortn 5473 (R2l S92)
INSTRUCTIONS: See reverse side lor filing instructions.
FORM
HC70
YEAR
CERTIFICATI T EMENT —
I(We) c i thai on the 1,�sIt'dray of nMar �h1ng
I(We) upied as our principal place of residence the following descnbed real properry for which omestead Property Tax QM6tYis�A2b�U.liNned:
I(We) owned ❑ Are buying under contract �
❑ Have a beneficial interest in the entiry that is liable for the property taxes on the property and that owns the prope r�s b� r
GIBSON COUNTY AUDITOR
CONTRACTRECORDED -
If buying on wnVact. Fee Simple ownels name
Recorders oHice where contract is recordetl � Recortl number Page
' PROPERTY DES IPTIO
Counry Township T g distritt "ry, , fo hip)
n m r ^ �{ ^ p� eg escription
�J * \/
�
If any ponion of the residenGal structure or Ne lantl not exceeding one (1) acre thai immediatey sunourMS ihat structure is usetl m protluce ir�come, describe ihe use and portion of
the property utilized to protluce income.
PROPERTV OWNED BV CLAIMANT IN OTHER COUNTRIES
Counry Township Counry
1
Signature cla"unani
ereby certify the above statements are [rue, correct and complete.
Address �n rand ' e!, ary, state, ZIP �
ASSESSOR USE ONLY �UE TAX � ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately ��)
surrounding residential improvements.
Oiher land (2)
Total Iand (line 1 plus line 2) (3)
Dwelling (4)
Residential improvements _
Garage (5)
Oiher improvements (6)
Total improvemenis (line 4 through line 6J (7)
Total value (line 3 plus line 7J (8)
I hereby Certify lhe above is Irue, torrect, and Sgnature of Assesor Date signetl
complete.
Verifying action - Signature of Autlitor Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead S
Vaiu tion 52,000
Signature of Auditor t sign � _^
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