Homestead_Like (3) TIATL torsi 5.17w10.r• +, TREAS11FIR FORM"3-IA
.APPReWED BY SI.AUL VAR°OF ACO,W1c,:nu Pr3Y111BWD BY Tit DEPART NEST L(EAL GOVFMNIDCF FINANCE K'6-1.13_4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS •PRINCETON IN 47670 Individual 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 fraud.Homestead fraud causes higher tat bills for all:therefore.
• HEA 1344.2004 requires taxpayers who restive the homestead standard deduction to verify that they are eligible to receive the
benefit ant to provide additional identifying information nearsan'to allow county government to better monitor homestead
tiling.. this information will be kept confidential and can only be accessed by authorised county officials.The Depanntent of
Local Government Finance will u c this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Like, Mary E/ Douglas K /
R I Box 450 dv
Fort Branch IN 47648
— 9454 -- -- - - .
Mary E/Douglas K Like
4005 W SR 68 State Parcel Number Legal Description
Fort Branch IN 47648
26-22-04-400-000.645-024 004-00645-00 PT W E 4 411 .59 AC
x
. PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
i
h O IGt5 l O.ri 1 L) <c
tg Address(num and street,city,state,and ZIP code) --- — --1I Some ns property eddies; — -- .-
Yo65- (A) s R 63 I-7- a rqnci,- --b /3 97671
( •
Spouse First Middle IL Last
mar/ E ) 1,,,,,_, L 1 1�,
Mailing Add (Number and street,city,state,and ZIP code) yl. Same as property address
1160,,5 w S2 lob Ft QrcinJ/ ZN Y76 yK
•
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.
net I Signature Date
III-
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
sme Form S�T3 (R7 � 5�
Praffibad by B�e DepeMah d Laral Goirernnard Fe�mwe
INSTRUCTIONS: See ieverse side /or h7"vig instructions.
FORM
HC10
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I(We) certify that o� the 1 st day oF March, 20_
� M�) �+P� es �Pal Place o( residence fhe "ng deso�ed real property for whirh a Hm�esteBA��}e�edl is hereby daimed:
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� � M�e) awned ❑ Are Wryug urda mntrad �
GIBSON COUNTY AUDITOR
Have a benefidal eitere5 m fhe entiry that's 1ia61e 4w C�e pvperly taes m the poperty and C�at owns the property or is buy'v�g under a contracL
S. c,:g � " i' F �'' .�':' �xH .�l: �'v 16� ^ SF . �u� 1 -� �
.f.��e. � .�..:. . ... t �.:e: . -..._., rxuP. .�. `..,�. CONTRACT<RECORDm.i�i+'- i_, ...•e•;f t..�,;..�.,���.. /;.:sf#"n 's-"'"+.�..w:y��.�.v�s!.
If 6uy'ug om m�hxL Fee Sirtqle oMrtiefe reme
fdemidefs dfice �here mr�ati is reonded Re�d number Pega
.�'�..'LL�7
Toastup
Legal desoip6on
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Is the praperry n quesCm:
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x afy partion au�e rmidud� smRZ.e a me Im�d na mceedng a,e (/) aoe mal :nmea�eJy e,rrav�m n,� mu�Y�ra ia used ro w��:�aome. desiabe me ine mw patlon
dtlre paparty,aiimd m pm�ce uimrtie. � . .
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Land rat e�rcee6rg 1(one) acre vm�ediately - - ,',�"�d ��" �� x''���t 'b �"
siarow�d'vg residenfial imprzrvemenls. (� � .. y�`S,u�J'� ���,�,;,�''.y. L��.� ��s:ir:2���r
:;,�,:sy;r�r • -
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Olher 18nd � �i';��.i;i:'::i.5:
Ta� lane (Ime 1 ph�s I'ne � (3)
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VwNY"i �4� �.eY1�k yf�i�at��4# 3 'hifR�iA ��tl
Resdential'vnp�ovemenLtorMmially . `.r..,.�r.o,,...Y3,..,1z.'Y�}.. ; . Y�.1•;;.<
Assessed bb6de! Manu!achaed Flort�e t�t k^rr �:�r, .ry-?r��',a�'t,��r�s4�-F'`i�,+
�� (5) n f������Z�,y.����',i.',��,nt��-.+4�
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:. i: � ..: i � '
Tdal 'vnprwernerris (!vre 4 Uvwx,� Bne b) m
T�I value (I'are 3 pds ffne � (g)
I hefeby certify tlie above is We. mrr�cl, and SiB�sa oFAsa�sar Date sq�ed
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Vailyilg arLOn . Si{p�s6ue d/4iQtw Date eipiwd
.a „'.'` 3 x;w"'*'�-"STlWDARD�.DEDUCTIOtJ/tLLOWAMCE + .n.,`?;7h �-? '.i».`},��",�r;�:."a` �`N fi�'�� `�`.�,�`'��
20_Pay2b_
Lesser of 12 Hortestead
Valuation a 535.000 f
��,�° �'°�=a a a