Homestead_Naas ., STATE FORM 5)569(0.1 I LIB) TEFASLTFR FORA!T5-IA
APPROVED BY STATE BOARD OF ACCOUNTS.IIW PRESCRIBED BY THE DEPARTMENT OF LOCAL Cg1TANMENTFNANCE IC 6.1.1-2141
Gibson County Auditor - ' IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNER'S'
101 N.Main Street Individuals and married couples are limited to one homestead standard deductioa As the receipt of this deduction becomes
Princeton,IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
• III- . benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.'This information will be kept confidential and can only be accessed by authorized county officials.The Department of
r �''v g� Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
�"1 T T }�I ;` PART I: PROPERTY INFORMATION
1 1 jJ i �. ,6' Taxpayer Name Location Address
— APR 11 2011 Naas,Garland CC/Barbara A
— X 1230 W 1 000 S
C.O. / '
HAUBSTADT IN 47639
7378 GIBSON COUNTY AU ID TOR
Garland C/Barbara A Naas IIDI11111CIII III 111IIII_II_�III 11111 IIIIIUII�II_IIIII IIII III_GIIIilCIIIiII II
1230W1000S
- Haubstadt IN 47639-8605 •
'I"III'III"dill'Il1li1illIIl'II'lll'illllltIlIlllllIllllltl"l' State Parcel Number Legal Description
26-18-36-100-000.746-022/E NW 36 311 2.867 AC
•
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
I_,i —___—__ __---.---____, -- __.._._PART 2: TAN P.Allft INFORMATION__ ____ __
a, _/Ii • / First Middle ��� S --_ .._ ._. Last
C3iJt l�1IGY C` . .
Mailing Address(number and street,city,state,and ZIP code) ❑ Same as property address
1023a scams t/ a 44 0 ,91 - 4e y74,3
,
Spouse - .First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) • 0 Same as property address
- ---- _
. Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
r -1— I -^ I— I H —1 —I --I - l =- -- I- 5>�
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:
pwnurt I Sigfp /) Date
F9RM HC lU 7979
ReuriEed By State BwrO of 7ax Commissioners
To & FileO in Dupli[ate
CLAIM FOR HOMESTEAU PROPERTY TAX CflEDIT FOA YEAR 1922
SEE BACK FOR FILING INSTRUCTIONS
�We � certify that on the 1st day of
arch, 19�, ,(We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (W8) ❑ owned
❑ are buying under contract /
❑ have a beneficial interest in the taxpayer �Ca -
Property Description in � �6 ��— County �
Taxing District (f,iFy;—�ewfr, Township):
Parcel Number
If buying on contract: Owners name �'� �""we °"1ef�
Oo r4-oo7f�� aa
' -/� -Q�.�S�-Q� 5�
Township
or legal description shown on tax statement:
L a ///G�/ � .�G - �-//-� �G 7��,
Contract recorded in Recorders Office - Record
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:
certify the above statement is true, correct and complete.
County Township
Scaie ana
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
�n the residence, or has a beneficial interest in the taxpayer.
� � -,F_OR�P,$SESSOR'S USE ONLY -
L� � �
.%� i: l`� 2 ,<, ?.9 79
Land not exceeding 1(o e) acre� m ed tely
surrounding residential �n� ovecfient ����
Other Land �� / �
Total Land
Residential Improvements
au�rro�
Dwelling
Garage
7otal
Other Improvements
T'- Improvements - Line (6) plus (7) equals (8)
I�by certify the above is true. correct. and complete.
O� NSSPSSOr
True Cash
Value
(1) .To 0
(2� O
�3� ��_ �
,�
(4) �., !• D
(5) f$-�c�
�6) _� .� � c;
(�) _'
�g� / 7 (o 0
Assessed
Valuation
/ 70
�� � �
�_ �
S-�a�7`
Date
�
Homestead
Valuation
C
- ACTION BY AUDITOR -
Date: _ �O /9��