Homestead_Epple SLATE FOAM!354.11C/w't TRFAStRFA FORM 73.1A
.APPROVED BY ST■TE>NAD OFAC[tLSTS.9n PAESCR®FD BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC41.1-_rl
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(mud.Homestead fraud causes higher tax bills for all:therefore.
0 HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive a the
benefit and to provide additional identifying information necesaary to allow county government to better monitor homestead
filing.This information will he Lepi confidential and can only be accessed 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 I: PROPERTY INFORMATION
Taxpayer Name Property Address
Epple, Cornelius G /Brenda K
R2 Box 221 A
llaubstadt IN 4763
- 179 . . ___ - — - - - - —
Cornelius G/ Brenda K Epple
269E 1025 S State Parcel Number Lezal Description
Haubstadt IN 47639-8042
lIInllnrllIIunIItIllnlulllInnIu Iu ItltIIu IFIu nIFII 26-19-31-400-000.309-024 004-00309-00 PTS 31310 .5165 AC
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- PART 2:TAXPAYER INFORMATION
Owner I / First Middle Last
Cdrne_IiU , G. \ CG) EPP1e
'g Address(number and street,city,state,amid ZIP code) —_.. - - - - la-Surre sus property Bddtta-s'-— - -- — --
c26, 9 C /nor S N d
a0bstd ! 1 N) LI-7eo3/
Spouse First Middle Last
Brenc1q Kc47 EPP1e-
Mailing Address(Number and street,city.state,and ZIP code) IN Same as property address
aev9 E /0 (-. ..5"" s /-]cw Sfadt -N 4-7(c 39
PART 3:CERTIFICATION
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
•'pert A1 Ude/rccS /S .2(col C ,oaSS , Ha.bcradt SrJ 474,"49
waM nc ia isrs ro ee Fam �n wpu�te
PreuriDetl By State BoarO oi TaM Commissioners y3
O
CLAIM FOR HOMESTEAD PAOPEATY TAX CREUIT FOR YEAA 19�
- SEE BACK FOR FILING INSTRUCTIONS
��� (We) %��'1; �/ff��i V �,�t� ,P� certify that on the 1st day of
^h_ 19 I, (We) occupied as our principa�� residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) �. owned
❑ are buying under contract
❑ have a beneficial inferest in the taxpayer
Property Description i
Taxing District (�GiLy—Tciwr�-Township):
Parcel Number
� � -Dd � 4! Da
�I� -/ - 3� �o -oao. ,3o9-aa5�
mty Township
or legal description shown on tax statement:
If buying on contract: Owners name ��� �""o�e owner� P� � ��� ,�j / - 3 - / o , $ /G .S-
Contract recorded in Recorders Office - Record
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: County Township
��hereby certify the above statement is true, correct and complete.
� �,�.�a �. ��-e , �/° f� � , �o�.��-�t.o��� .�^- � '�1E 3 q
'Signamre r� Sheet AOCress Ciry. State ana Zio Coae
' 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 -
Land not exceeding 1(one) acre immediately
surrounding residenti�m�rov�en� �
Other Land
Total Land
Residential Improvement�J�jy 2? �g�g
�ii" . � j�f �� p�
� AUDITOR
Oiher Improvements
Dwelling
Garage
Total
Tr• '-Improvements - Line (6) plus (7) equals (8) �
I�:,�y c the above is true. correct. and complete.
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Signa:ure ol
Approved
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Date: � � � �