Homestead_Nichols it
' STATE FORM IIMIR:/5-711 MREASLIII PORN 73-IA
.AflnEO BYSr.IL BnsROC*NTY*'NTS.5a PRESCRIBE BY fir DEPART ffNT OF LOCAL rOVERYMTAT FINANCE le 5-1.1 1_4.I
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 recctipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills fix all:therefore.
• HEA 1347-21109 requires taspasen.who receive the homestead standard deduction to verify that they arc eligible to receive the
benefit and to provide additional identifyine information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be accessed by authorized county o ficials.The Department of
Local Government Finance will use this infommtion to create touts that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Nichols, Thomas W/Debra A
•
'timers Crossing off I
•47639
7248 o
Thomas W Nichols
1201 W 1000 S State Parcel Number Lezal Description
HAUBSTADT IN 47639-8605
III nu I I I I II I II I I I n I I IIII I I III 26-18-36-300-001.890-024 004-01890-00 HUNTERS CROSSING 3PT/5
o n
t t t t t n tot t t 11111111
2:TAXPAYER INFORMATION
Owner I First Middle T Last
`✓ho OK LIes/e y echo/s
. t _ _
to Address(number and Street,city,state,and ZIP code) Same as property address- –"_ — --
/,20/ W /acs S #40g514444 zN 4/Z39
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) 21 Same as property address
. 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.
Owner I Signature
0)/t/ Date
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDR/STANDARD DEDUCTION
State Fortn S173 (R6 / 1-03)
ResaiDed hY Me DePart+nertt of Lxal Govemrtant Finance
�NSrnucnoNS: s� �,.�o �rdo ar�any:�nwb.
.,
QU FORM
� HC10
� /'�'- '4T, � �
YEAR
�(VVe) /'
(y thal on ihe 1st day of March, 20_
I(We) occupied as our principal place oi residence the following described real pmpe (or which a Homeste ��op� ��edit is hereby daimed:
G
❑ I(We) owned ❑ Are buying under contract
,� Have a benefidal interest in the enti that is liable (or the ro e taxes on the ro e and that ownIBSON o OUNTY. AUDITOR
b P P ny p p rty p perty or is buying under a contraG.
If buying am m�Vad. Fee Simple owners name
Recwdefs ofice where mnVaq is
Couny
Tamshi0
ra�✓ V vr� , D/ �/ O���gai ueSCnp o I
� �L� �� �/n ��
1/ any poAion o/ Ne residenllat sW cNre w the land nd exceeding rne (1-� j acre
ol Ne property utilaed tn produce incame.
�� a�-��-�3�-��2�0_
County
I hereby ceAify the above sfatements are We, corred and complete.
Ssfafe,
Tating Cistrit . t
�� Is the perty in
iateM Nats ctu
County
Record number
Pa9e
al property ❑ Mobile Homo (LC. 6f.7-n
is used W produca income, describe Na use and portian
-�j�^ i����4�'"`�'-'r'��"'�rd'��}, � TRUETAX'��'x �ASSESSEDVALUE �+HOMESTEAD�$�� NON=RESIOENTIAL� �
-• � ;.
- �^- ASSESSOR USE ONLY� �' � °'�T ,v VALUE
aR; . �' . . `�`T.�,.XR ±�#}�"�n..'..�i�E'�r_ �;s,�VALUES t�Y�+ "AT3100°�'O v.�V-..6 o�t. s��VALUE.'m�_`Y�.a�`�` �-�*t�i..�.. �::,n"'`��
Land not exceeding 1(one) acre immediatey s� � �"�" �"
surrounding residential improvements. � � �� �x�.�'���= �t �
( ) �. .- ��'�, � � � , �� �.=�
Other land t �"` "�'1� �L Y � �
Z f�� 4
( ) tr t�.'-�E
�r..�a.T'.1' r :�
Tdal land (line 1 plus line 2) �3�
� �r-r.�:>�€ ,z.r� �� ��_:
Dwelling (4) � n'= �o-v'� �'"` Y�
�ResidentiellmqovemantsaMnuatly �'-��"�`x��.s.�i ��.��
Asaassed MobBe / Manufa�red Flame Gara e %�-�����'-�,,� �'` ",
9 (5) "" 4���c�� � � ���
Other improvemenls (6) �����
�T=
;�tl 3
Tatal improvements (line 4 through line 6) (�)
Trtal value (line 3 phs line � �g)
I hereby ceAify fhe above is W e, coned, and Signawre otASSessor Date signed
complete.
Verifying action - SigraWre o!lwditor Date si9ned
20 _ Pay 20 _
Lesser of 112 Homestead
Mewaum a f35.000
Signalure
5
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