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Homestead_Fleming (3) • SIAM IORM5MWgR=r■•• TUASULER FORM TS-IA AP•I*e•BY SI ATE Bout)nrArrotNic.l PREalintiD BY nil DrrAftreff OF LOCAIGOVZIMNIEWT Fn:AYCEtt'41.I-224.1 Gibson bounty Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 44767�0p--� Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes RIP p mare beneficial there is more ayets wh rec ive (or hama'tead fraud.d deductio (mud causes hit h y tae bills le all:therefore. gYB HFA 13i-1-?W9 requims mvpaven who receive the hanestmd standard deduction to verify that they ale clicihle m:Here the benefit and to provide additional identifyine information nece■v�ry to allow counts'government to better monitor homestead filings.This information will he kept confidential and©n only he accessed by authorized county officials.The Department of APR 1 4 2010 Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Pro'env Address '7140 e494 Fleming, Joyce/Kerri Ann •GIBBON COUNTY A 9!TOF RI Box 373 (/� L. Haubstadt IN 47639 N 9420 Kerri Ann Fleming 1177 W SR 68 State Parcel Number Legal Description HAUBSTADT IN 47639 IF I Li Fs 1,s 26-22-01-102-000.537-024 004-00537-00 PT E W 14 11 1.732 AC APR 2 0 201U • gIBBON COUNTY AUDITOR PART 2: TAXPAYER INFORMATION Owner I First Middle Last �g. • (number and street,city,state,and ZIP code) ___—-__ _ -_ _—._:-Same as progeny add: _ __ _ _- •'. . Each undersigned certifies,under penalty of perjury,that the above and foregoing infonnation 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. y Date • CLAIAA FOR FlOMESTEAD PROPERTYTAX CREDIT/STANDARD DEDUCTION smm ro� s+re �� i sa� Prewbed by U�e Depa�ierA N loml Gouaimerd Feianae INSTRUCTIONS: See reverse side fw Ring instiuctions. .. . . _. . ...... .. .,. FORM �R �o � �(M�e) . . cerhy tliaf'oifUf�N�n� Ma1d� Z(1_ I(We) ocapied as aa ptv�dpal ptac�y( idence Ine 'rg d I poperty for whirli a Hanest� y{ � daimed: C.� �M�l � ❑ ere �5 Have a benefidal inmresl m �he entiry is lia fw the poperty taxes m Ihe property and tl�at owns Cie property w is buying urMer a contracl -.'y �..F: i �.. , rra`�'-.:t: '. ``'..:..COlfIRACT:RECORDmi;:��� s„ . ..a.:i�.X�' � ''i'� ..F.`:SM„?:f�htxi. i a.?��'`.!r`�.�i,�.r�<�": M G+Y'n8 am m�trari. Fee Si�1e wrets r�ma � f�Wrdefs dfice whae Wrt�ed is recarded Recvd number Page �+b � �� N' ?."c'i. Ta�hip Leg� d�cripdan � .. ,. ,. //�// / ,�ii : ,�: •� _,_� tt arry porlion d �ha rmideNial �ue ar the Im�d nal e<cee0inp ona (1) aae tlmt inmadda�9y au�amds tl� d�,a��m��. i. ��a� a�-aa-��-�oa -000. s��-�a y ��ry Tawnship I tlefeby oeflify tlIC 8hov8 Shd�(fIPlIL 8f8 WB. CAlfBGt 8fld Wrt41eEe. (IIIJIbB! 9I�d 3trbB1, On; � � paperry LJ Mahib Fiortia (lC. 61.1-� � uaed b ptodice iimrte. dextbe tha tm anE partion ,.-.. GI � .. �' � ' . . � . �. ," �'`�'7�•r� . re 7RLJE TA7C �' ;. ASSESSm VALUE � HOt�S7EAD � � �C".,*'�KNONRESIDH�IML° �'��' : t • • � /1SSESSOR U� ONLY � . �' .h��'t� sP�S.2n � �q' . � �E,%Y �. �AT 100% OF 77V i i °' VALUE 'd '� ��+.�'r'i7 ""cY VALUE, � r*"" ,�%�p a''S.�Z�.." )A8 � . .,�..b.� i t .. .. �n e� he,.,M�'���nw 'F�; ., aC Land not esceedng 1(one) acre irm�mely (' � `r�: ��"9*€^,?=•7�(�.� �� �'`/��i�� S�ufwnd'Rg residenfral improvert�enb. y t��y+e{r}¢.t'a�' ;l:� �;`��`:.T'Sr-�;:��:;£! Otlrerlard (p� ' ,. �'�'�: •�'��r � :•:: :��,.h�• [{'•4'i Td� lard (I'sie 1 plus 6re � (3) �, � ��` i� �* `�' cri�.:�c�'.Ck4°�'P�1s' Resdentialimprove�:ie�tsaMrwaly ��� . (4) �-'..����,�:�'�t;i?CVaw�«.'��.'�„�.�h4� asse�ed Modle � n�arn,ra� Flarne :k�.'�'x.�;�(' r 3,,°c����;<,r,y�,���t; ��e (5� tfe�.�i7�:�>p'z?y�7s�t�,��'}� .� �.r Olher'unprovemenis (6) ,.�,'. -`. _ ...�-'..'j � Tdal'vrqmwert�erAS (6re <Waigh 6ne 6) (�) Tital value (I'ure 3 pGs 6ne n (g) I liereby certiy fhe abwe e We. oonect and S9�ve ot�s�o Date sSp�ed �� Vaiy'vg aWm' SgaNe dh�dtar Defe signed - � „ �r. ,`.?;'� ��. Y,�','h,.,<aCi:SLWDARDDEDUCT101!'/tLL'OWAMCE �c.v;3 ��1�: � v���'kaS:vr�.�, z '���i"r``�`�:.f. .� 5. ..u+ M r, e..4 aPe.v a:r 20_Pay20_ Lesser of 12 Homestead Valuation w S35,OD0 S Si�ce olAudmr � �