Homestead_Petitjean (8) turf FORM!))Mnt'r"-WI ThFWhin FORM:SIA
amrIMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 61.1-224.1
Gibson County Auditor
101 N Main
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 eta for homestead fraud.I Iomestea)fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to reeene the
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 Dcpanntent of
• Local Government Finance will we this information to create tools that will help county offciats eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Petitjean, James/ Elizabeth
iim 12608S350E
llauhstadt IN 47639
10968
James/Elizabeth Petitjean
12608 S 350E State Parcel Number Legal Description
Haubstadt IN 47639-7953 •
lIjndit�r��rtujjtjtjnjnt��t�nt�tjntjjt jjntjn�t�t�nj_ 26-23-14-300-000.778-024 004-00778-00 PT SW 1441047.71 AC
u —
PART 2: TAXPAYER INFORMATION
Owner I First, Middle r Last
Tames F. pa 11 t'ea�I
•ng Address(number and street,city,state,and ZIP code) — — — - 0 Same as property oddress ' ' - • — •-
Spouse First Middle Last
lizaeth A, )°eti f'eah
Mailing Address(Number and street,city.state.and ZIP code) 0 Same as miserly address
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
•,
FOflM HC 70 19i9
Presai�e0 By Siare Bw�a ot ia. Commissioners
io Be FileC in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOR YEAR 19�,�
SEE BACK FOR FILING INSTRUCTIONS
�(We) � � certify that on the 1st day of
arch, 19—Z�, I, We) occu d as our principal plac of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (we) ❑ owned DQ � �QQ ���— Q ()
❑ are buying under contract q/ �3 /—� �• �7 p_���
— ❑ have a beneficial interest in the taxpayer OfCo Q
Property Description in � County Township
Taxing District (�Gii-y, Team, Township) �i�+—a��
Parcel Number
If buying on contract: Owners name ��� simo�e o.�en
or legal description_shown.on tax statement: _
�T, —s'l�/� /5�-4�—io ��9���
Contract recorded in Recorders Office - Record No. Page
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: County Township
hereby certify the above statement is true, correct and complete.
� �
-# aC..
�'Si nawre Sveet AOCress C y. Staie ano 2ip Cotle
� �� �g
Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY
Land not exceeding 1 r t�{�j'�
surrounding residential �ro�em nts� 1 �
Other Lantl �' 1� L�
Total Land ��N 131979
Residential Improvemen/ts� LI Dwelling
�1 • �i / (iuJ2�arage
(� AUDITOR Total
Other Improvements
Tr� Improvements - Line (6) plus (7) equals (8)
I�hy cer,Nf�he above is true, correct. and complete.
Signamre ol
True Cash
Value
� i � Sso 0
�2� � 9 9 0
�3� _�� 9 6 i
(a) �o y O
�s> 2 9 0
(6) �G3 � o
(�) /-S`"4� O
�8� �"9 2 0
Assessed Homestead
Valuation Valuation
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zo
Da:e
S—� 3 -
'� ' - ACTION BY AUDITOR - .
Approved: ���� '�A Date: G