Homestead_Conklin (3) STATE FOIST Mt.Ile I s-B) TREASIIRFR FORA(TSIA
.APFRfWEO III MAIL BOARD OF M.YT NSTS_!mr PRF_WPJOEm BY THE DIPARWEIT{W VEAL CAIti[0.NMTNT FINANCE ICLI.I•L'-F.I
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 of this deduction becomes
more beneficial,there is more incentive than eser for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
*FILED HEA 1 iii-2009 requires taxpayers who receive the homestead standard deduction to verity that they are eligible to Ittene the
benefit and to provide additional identifyin_ information necessity to allow county government to better monitor homestead
filings.This information will be kept cnn6demial and can only he accessed by authorized coon v^m^i,L. ]h Depanntent of
Local Government Finance will use this information to create tools that will help ,.-officials eliminate homer td.
OCT 0 1 ZULU PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
0. ,Q t Conklin, William E III/Carla M
GIBSON OUNTY AUDITOR R 2
Haubsiadt IN 47639
3185 • p_ ,d _ /William E Conklin III �'`O
4409 E 950 S State Parcel Number Legal Description
HAUBSTADT IN 47639-7826
Itlnllntlrllnnllrl rlt tlnrllnitultltllmlltnlJultlnl 26-19-35-200-001.822-024 004-01822-00 0 PT NW NE 353104.01 AC
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
A Owner 1 'I First r Middle /h � I .�� Last
•ng Address(number and street,city,state,and ZIP code) 'amc as properly address
'I 'ibl E 9 SD 5 VIA 5-1-- = /U 47 _3
� ��ii.Spouse First Middle Last e_.0,._,Ki, IA_
Mailing Address(Number and street,city,state,and ZIP code) .1—):Same as property address
LIiid9 F '5--o S it',,>�os-/—ctoi..± / —TN 73 5
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 properly. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
A Owner I7 agate �/ & ..., / Date
IP
' Sfata Fwm 5473 (R6 / 4A3) Q.OS->. t-Z a? �
2ertR�JE94��?dQY;�PAASVi�V?ef!1�M.l0�al GwemmeKFi�ance!EU;. �i�&3 �ol ;'ue �; tr I �h�un�� � :v;+!� : n: �r
(itb�:?ta.^ti Y1t9(�O in le9' iSl?^3QIi`vi
YEAR
, �__�,/7 j ///1 � o —
� (N�e) __o�L� F //�rrY�eF.v�o �� "� :�:YQa=i � .. . . . - , .f. :.�: is r 3certify tHaFnmthe 1st day of March, 20_
.i.. - .t,. . _+ .�" y
I(We) occupied as our principal place of residence the follovnng described real property for wM1iGi a�Homestead�PiopeA�aiC�te�'rs�np,teby daimed:
C/
❑ I(We) owned ;`zyQ�tAre�Mryiagamderrthitract�:dt c�itn ni p,ntlr.:oy�.,a o E� •".rll.' \'Y^u os-_�.'j !euGivGI6SON �COUNTY AUDITOR
di v�i.:•.,n••• 1�Nt - n�i:•^oA N.•:'+,:1 2l�; n,l .'r[�`::�M •-•,,r,�:r.o i=nr�u r,-� n.:,i oi tC �A'N]'ISf�1t9
� Have a benefidal�nterest In tfie ent�F�1{fi'ai is Gatile for the�roperty taxes on.ttie,property and tfiat owns.the property or is buying under a wntract.
bOE .,_fgb129'! n: r.o ..=zs! Y;:>.�c�.; ��:: �_,o o: e Iya:�. �er,t w� �u:�o�.�.�n; �,.
If buying on conVad,
Re ' ei''S 6 � ' he
ziinci?:;4is •�c z�?
�.�"�`�"',�
Countyy/f.v Sc?i65�'
H any
ofthe
Fee Simple ownefs name
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e.:-u;��n7a rr�l ic zmoc� c�;6x �nc !11 �Ui12 ZY�:� ]L _O'��.P \iuEiJ<I E. ,91J!'�Ui'? 5N
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.. y�.. �.� :: t�en: ,� .�i:nr'.
..7
3�.s���—���v Ir7 ,tl7/Ption v IsNePro
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of Ne residenUal sWCNre w the Wnd n_d exceeding�,one_(7) atte �hzbimmetliatety.surtounds that
y utiliZed to produce income. '
question:
9�:7
asrizeb !sut^.�bni ns tI ha;s�n! zi i�ss::ar�on ::9 >u,.'.�•� �;m.wa 4:c r.i �=e z`:o: :�,F� ��l;�c�:i �r'� �c �,i:� �� :2�� ;=_rtno9
.a:�io iio;!c:iA :_;:�uo:i sdl ::; �pr.igV�9 � 3yiltiJ2 ,]9?3�i?FFiE ry;L tl gniV:i::) 7::::tl 9tl ,L'Oi�l'1;9:!:j!.S,)nt 9:�7 aVEfi OI
aJ
County )� Tavnship :tc r,:�:;, s u•r�tqqr. ivn Y�Colirily:w �:r,U[v en:
:z)r,_re:s1J!ns-;!'in =��on ;c i.S :.vl R: � �91J d.^.(.^.rdtAl� ,leg� ':tfh2 9(B ot.teuc�romni �n', i+ 1
I hereby certify the above statements are tnuaconecta�d��,complete:�
ir.e,T �:;qs h3: �i �e
Mobile Homo (/.C. 67.1-7)
brne, describe 1ha use and portion
:3JIz li7 WOH
� �a� x `�'�'y*^,.��^'��' � - k` r , ��- f' �+EY � -^�.yTRUE TAX "� �ASSESSED VALUE '��HOMESTEAD�° � NON�`-RESI�ENTIAI 5
�.�,'!'-y� �xASSES50R�USE ONLY � � .�rx'� i ,�,y�UE=��k� � 4AT.100%'OF�TN ��1.,�.VALUE�'<#�; �' VALUEs�-" �
_ �x.�F- . '-K .:`4R�a:t�_'-x=-._ _����� ��. ��. r. - ..:... . .—�-.+.-..,. �.'�."5�^T-...w�',+�:" C.3ez��5.. ,,....:,,w.�i.-�rJi�
Land not exceeding 1(one) acre immediately -_ ,�'� ��,���'L%r�dr';
suvounding residenlial improvemenis (�� F�� ��§',,,��.����'
L'yl's�,i,vyt''`"".y$, ssv�, -..
Otherland (2) ���'?i- ��
;;fi,, _,'�.a' �:.'r�
..�Ax_.i: �,b%?s?�Cl�t
Total land (line 1 plus line 2) (3�
�q �.y ��� .f ic:.�h�Y.-.'�i
Dwelling (4) �. „ � .y � � �,y� s
�Residentlal improvements or MnuaOy ������='�-'��'�^��
Assessed Mobile I Manufactured Home Garage 5 ::-�'�� `�`��� -,� --� �.-'�*`' �
� ) l�L��.des. ' '�.���
Other improvements (5) a � ��;'� ��' ~
'" �F -�S't�
Tdal improvements (line 4 through line 6) (�)
Tctal value (line 3 plia line n (8)
I hereby certi(y ihe above is We, correct, and Signature ofASSessor Date signetl
complete.
Vrrilying action - Signature oflwditor Date signetl
°�E�°°�..,t.�S�i:T��T�'v'''�,vs`�� -s�'.,_�'�,rSTA1JDARD:DEDUCTION'ALLDWANCE kznx%yYhv4a���+�ru.-�ue„�'""F +:^�,_:'" �..s`�" "� '-
.'�. �5�''�` .�58'i�arc_ �=:=
20 _ Pay 20 _
� Lesser of 1!2 Homestead
vauauon or 535,000 5
Signature otAuditw ' Date signed