Homestead_Novotny SlAFE FOAM!1 W 1t/SWI MEASURER mAM 11A
.ArrMnEDOTSESTE k5SO OFMtVR.TC2nx PErSYIUBrn By nit DEPARTKER OF L0.5L GOVERNMFN7 FIANCE Ks-I.1-U4.l
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 deduction becomes
more beneficial,there is more incentive than ner 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
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kepi confidential and can only be accessed by authorized county officials.The Depanment of
Local Government finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Novotny, Bryan J/Stacey L
Joy Lane
2658 0�
Bryan J& Stacey L Novotny
9810 S Joy Lane State Parcel Number Leaal Description
HAUBSTADT IN 47639-8612
Ilnitiu t1111 liii 26-18-35-100-002.179-024 Sunset Acres 8
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.
Spouse First Middle Last
SMON LyNrJ NJ0V y
Mailing Address(Number and sweet,city,state,and ZIP code) �y Scone as property address
IQ S. ,Uy l a,.> Ra .b dA 1 t3 41631
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 Date
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
Stete Fortn 5/73 (R6l M3)
Resrnbed M the DepartmeM d Lncel Govemment Fina,xe
INSTRUCTIONS: See iv�arso Ndo b�"rp iwtn�c0ant
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I(Vj(e) occupied a ur principal place of residence Ihe ( I wing de cribed real
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FORM YEAR
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'- certify thal onthe' ���f't01a`�ch, 20_
which a Homestead F(gy�tyr7�r,g��ig t,�e,4q��imed:
I(We) owned ❑!ve buying under contract
Have a benefidal interest in ihe entity that is liable (or ihe property taxes on the property and that owns the property or is buying under a conVaU.
11 b�ying on conVad, Fee Simple awnefs name
Remrdels ofica where conVact is recarded
Counry
Parcel
If any portion ol Na resid
a u,a �oPeny �w�zea �n
To.mship
Oislrict (ciry, (own, (ownship)
Recard number � Page
scnption Is Ne property in quesUon:
�%f(1� � ❑ Real Dropery ❑ Mobile HOma (/.C. 61.7-�
na exceeding one (i) aae ihat immediatety surrounds Ihat swaure is used b produce inmme. describe tho use and portbn
_in -.t�- inii-
�> �"'"- �' 7��-�'"'�t#_ nSTANUARD'AEDUCTION'ALL'OWANCEc`:.�"'-�'e.�-i�`i...i:i`u`?�3-3'ifi:� + aari:�* :
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20 Pay 20 _
Lesserof 1i2 Homestead §
vauanon a f35.000
SignaWreO�Auditor � Dalesigned