Homestead_Fleming t
'f of FORM!!rt 0t:I,+.nl MEASURER EORV:SIA
APlMSED BY STATE.INIARDOF MIY nn.y.0 PRYTIBFD BY fir DFPART¢WT OF L0.AL mvrr.sslnc FINANCE K i.1_t.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 e'er for homestead fraud.Homestead fraud causes higher in bills for all:therefore.
iv HEA 1344-2009 requires taspasers who receive the homestead standard deduction to verify that they are eligible to reecho the
benefit and to provide additional identifying information necessary to allow county gm'emmenl to better monitor homestead
filings.This information will he kept coaldentinl and can only he arse:sed by authorized county officials.The Depanment of
Local Government Finance Mill use this information to create tools that will help county officials eliminate homeatcal fraud.
=PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Fleming, Donald R/Joyce E
RI Box 373 \\
Haubstadt IN 47639
9417
Donald R/Joyce E Fleming
1217 W SR 68
Haubstadt IN 47639 State Parcel Number Leoal Description
26-22-01-102-000.321-024 004-00321-00 PT E W 1 4 11 1.925 AC
X
• PART 2:TAXPAYER INFORMATION
•ng Address(number and street,city,state,and ZIP code) U Same as property oddness - —- ——
/a) /7 Co c cop . JVaubtsito-d-1-,-TN 47639
Spouse First Middle - Last
J ce Evc/y )J F/r°m /iij
Mailing Address(Number and street city,state,and ZIP code) ❑ Same as property address
is / 7 w s i z t 8 //oohs/Lad J i Y7,39
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
el
•
FOqM HC 10 7919 ' V To & FiIW in DupliWte
RescriGed By Slate BaarO of Tax Commissioncrs
CLAIM FOR HOMESTEAD PROPERTY TAX CHEDIT FOR YEAH 19��
� --— — —-- —
�(We) ��"%�—� �� L4" �-� �� ^ eertify that on the 1st day of
arch, 19��, I, (We) occupied as our rinc al place of residence the fol ing described real property for
which a Homestead Property•Tax Credit is hereby being claimed: 3�`��Oa7
I, We ❑ owned ��DD �/�a'
c ) � DD � ,?/-da -
❑ are buying under contract
❑ have a beneficial intere� in the taxpayer �,
J
Property Description
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name �'� �""o�e owner�
or (�gal description shown on
O.�-. ,� %.. � %
Contract recorded in Recorders Office - Record
Township
tax statement:
/- �-/i /.
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:
' hereby certify the above statement is true, correct and complete.
� %1 � _ , .,
County
Township
' 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�pr�vem�nts � �
Other Land �
Total Land
Residential Improvements JUL � 0 1979-
Dwell}ng
���/��k�� // uarage
+� �«tal
Other Improvements AUDITOR
T �� Improvements - Line (6) plus (7) equals (8)
I�aby certify th�above is true. Gqrrect. and complete.
SignaNr¢ ol AssM50r
True Cash
Value
(�) ��
(2) ,�"D
(s) �-f—a___
c4> aoss o
(5) —�—
(6) o? O S S D
(7) /� � O
cs� �/�30
- ACTION BY AUDITOR -
Assessed
Valuation
/7 0
,L�B
,.
�� r
.,
' •
Homestead
Valuation
�- I 9 - �,9
Da:e
Approved: /� • �-/'. r ��J Date: � 3� ' / /
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