Homestead_Frohbieter (7) •
•` "IE FoKNI!!•IR:/uNl TnrAsUImA fORM TS-1A
.Ar•WW'ED BY CTVEBIAPOoFAIMIE t'.vM PBFSRIBm DV TIE DEPARTWVr OF I K:SE CAVEANNItla FINANCE MVt.I rot
Gibson County Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
• more beneficial,there is more incentive than ester for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2000 requires taxpayers who receive the homestead standard deduction to verity that they are eligible to reecho the
FILE benefit and to provide additional identifying information necessary to allow count'government to better monitor homestead
A�) filings.This information will be additional identifying
confidential and can only be aco allow
by amhnri/ed county to better The Deponent of
Local Government Finance will we this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
APR 1 4 LU10 Taxpayer Name Pro. y.Address
77/. '/ Shelton, Patricia A
0 /Qt R 2 13ox 200
8AgfsON COUNTY Auorton llauhstadt IN 47639 Q`
Patricia A Shelton
629E Eisenhower Lane State Parcel Number Legal Description
HAUBSTADT IN 47639-8035
�r�r r��ttt�t��tttt��r�t�tt�ll IIt� ��rr�r�rtr�r��r�trt�tr�� 26-19-32-101-000.908-024 004-00908-00 MACK CURTIS 24
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
�g Address(number and street,city,state,and ZIP code) .- - - - - I I Same as progeny address - '-- — - — - - _.
629 C its-eh Itn-ven> ,Ln IaAbcfo.dR'flly7&3y
Spouse First Middle Last
Mailing Address(Number and steel,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sae
PART 3:CERTIFICATION
Each undersitmed 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
S
warn Hc io ism
keuriOeE By Sta�e BwrO of Tax Commissioners
To Be FileE in DuDlicate
G �� te r IM FOR HOMESTEAD PROPERTY TAX CAEUIT FOH YEAR 192�
rO���=fT°'"'"' SEE BACK FOR FILING INSTRUCTIONS
_ oD� oa9a�oo
�(We1_ �h�� ��i,.« ./L. � , certify that on the 1st day of
arch, 19��, I, (We) occupied as our principal place of residence the following described real property for
which a Homestead MProperty Tax Credit is hereby being claimed: //
I, (We) G� owned �' 1 � � Lg— � � �lo —�� e�o1 _�Q/— �.94d" � 60� 7`"
❑ are buying under contract
O have a beneficial interest in the taxpayer
Property Description in �
Taxing District (6rfy--Tewrr, Township):
Parcel Number I
If buying on contract: Owners
nty Township
or legal description shown on tax statement:
i�'u�l �z� ,�� xsl
Contract recorded in Recorders Office - Record No. Page
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 individu�wns or is buying real property: County Township
/
�' hereby certify the above statement is true, correct and complete.
��
����✓ � �/��� ��P. � � �-� ,�✓ � �
Aaaress
:�-�G ..(� f��d
Ciry, Sta;e ana Zi0 �e
Individual either owns or is buying under a contraci 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 -
' True Cash
� '� Value
Lantl not exceeding t (one)g[�re�mr�ec�ia�y
surrounding residential impr�rem t� (�) SO
Other Land
!t1'W 14 i979
Total Land
Residential Improvements ,�,/ �i ����i�9
�/i (� AUDITO�
arage
Total
Other Improvements
T�' 'mprovements - Line (6) plus p) equals (8)
I�`y,csLity the above is true. correct. and complete.
-Signamee oi
(2) —
�3� -4�S o
(4) 'S�G 5`0
(5) . �.
(g) jLloS'O
(�) �'0
(8) `�� 3 �
Assessed
Valuation
.
�jjj�j�j�
i �
� s t�
.
Homestead
Valuation
S-� 5�- 7
Da�e
- ACTION BY AUDITOR -
��
Date:
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