Homestead_Kern Wit r ORM!3M.,R_/ ■rl TREASURER FORM 13-IA
ArPMn'ED BY SITE&simor MTxL■T1.Zan PRratt1BW BY 11W DEP.10.TQNT(W LOCAL 00,CER Mrl.T Fe:ASCE r
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 dedlctian becomes
® more beneficial,that is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HE,\ 1344-2009 requires uxpa,ers who receive the homestead standard deduction to verily that they am eligible to recebe the
benefit and to provide additional identifying. infomauon necers�ry to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be accessed by authorised county officials.The Ikpanntent of
Local Government Finance o ill use this information to create Ws that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
•
Taxpayer Name Property Address
Kern, James/Marilyn
Kt I Box 261c
ilaubstadt IN 47639
11138 0�
James/Marilyn Kern
12644 S 40 W State Parcel Number Legal Description
Haubstadt IN 47639-8714
�r�rl��rrt�r��rtrr��r�L�tr�tt�r lrrtlttt��t�t t�r�tr�r�r L�rr��l� 26-23-18-300-000528-024 004-00528-00 PT W 18410 .55 AC
X
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
A L1 h 2rAs
I
®ng Address(number and street.city,state,and ZIP code) 0 Same as property address
A) tti
Spouse First Middle Last
q r: / S 44-C_
Mailing Address(Number and street,city.state,and ZIP code) ❑ Same as property address
/d G 2' 1-' !��_ 4.4 /-t'-,
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.
Ow�namhc Date
�
CIAi��1 FOR H(X`'�STEAD PROPERTY TAX CRmIT FOft YEAR 19$'�
SEE BACK FOR FILlNG INSTRUCTIONS
_. .
� certify tl�at on the lst day of
ce of residence the follaaing described real
is hereby being claiu�d:
I, (T•'e) �'6c+'na9 . U � �"D ��iCQ —�d
� aze buyinq urrler wntract p O
� have a beneficial interest in the t��e �3 /O - c3LY1- D� •�o�O - L� �
Pro�rty Description in / aie County �l�IiA�so �/ Township
Taxing District (City, Twm, hip)
Parcel Plimibes or legal description st�m on tax statanent:
�i: w �% /y- y- io . ssa.� .
If buvina on oontract: O.mers name (fee simple owner)
Contract recorded in FPmrder's Office - Record No. Page
If any portion of the residential structure or the land, not e�eec7ing one (1) acre that
imne�iately surrow�ds that structure is used to produce incane, describe the use azrl portion of
the orooerty utilized to pzoduce income
Pny other mimties in which i-ndividual owns or is buying real property:
��ty Rtr�mstup
�y certify the above staternsit is true, o�rrect an3 cong>lete.
*Signature • Street Address City, State ani Zip Code
*Individual either aans or is buying imer a o�ntract that provides he is to pay the
property, taxes on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESS(1�2�5 USE ONLY -
True Cash
Value
Lar,d not exceeding 1;one) acre irt¢nediately
surroun3inq residential i�rovenents (1) �o 0
other Lana
Total Land
?,esidential It�rovar�its
Othes Imorovanents
IIaellinq
Garaae
Total
Tc' '• 7�rovelrents - Line (6) plus (7) equals
Z hereby certify the above is true, correct,
Assessor
(2) —
(3) Sso
�a) 3 &is � o
(5) �
(6)
3� 'fo
(7)
(a) (a) 3Z8�o
and �lete.
- ACTION BY A.UDITnR -
rinoroved: Date :
Assessed
Valuation
/70
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Dat.e
�r-
Hrneestead
Valuation
/70