Homestead_Potts (3) -
5IAI f FORM!)!M tR ,NMI MIASMA FORM ASIA
Ar Itt310 BY SLATE EOMOnf Mr011,73 9r, Perx,1awbY THE o6PARmWNr(w LOALrA\2RNMR.T MNANCEKHYL4J
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 dedtlnion becomes
more beneficial.there is more incentive than an for homestead fraud.homestead fraud causes higher has bills for all:therefore.
1 110 HEA 1314-3009 requires taxpayers who(ccive the homestead standard deduction to verify that they are eligible to remise the
benefit and to pnwide additional identifying information necessary to allow county government to better monitor homestead
tilinp.Ibis infnrmnion will he Lepr confidential and can only be accessed by authored county nliiade.lie Department 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
_ Potts, Corey Alan/Jessica Ann
R2 HOX 551
I IAUBST.AD'r IN 47639
10927
Corey Potts
R2 Box 551 State Parcel Number Legal Description
HAUBSTADT IN 47639-7853
26-23-11-200-002.230-024 WHISPERING WINDS SEC 3 LOT 20
r at II ur Ir II un II I I r I liI ut II itI n I r I ur II n II nI tlr'io II-_-
—
I PART 2:TAXPAYER INFORMATION t
Owner I First m Last
g Address • ber and street,city,state,and ZIP code) - _ -- - 1 j Same as property address " ---" - - -
a 65- J. v. CI, &u 31/c ... ,
Spouse First Middle Last
(Jai. Ti C a - n 'P hi 5
Mailing Address(Number and street,city,state.and ZIP code) Same as property address
l 0 f t i C . /fat/ s - , /
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 A. liable for back taxes and substantial financial penalties.
Owner I Si. • ' Date
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
S�U Fam 5173 (R6 / 4-03)
Rewibed by tM DepartrtrorM1 d Loral Govemment Finance
INSTRUCTIONS: See iewrs� akb b�p im6uOpry.
FORM � YEAR
��� '
� M�ei _ �GiO `cerG� that�fl tl�,1sl day of March, 20
I(We) occupied our principal piace esidence the following described real property for which a Homesfead Properry i�crCredit is hereby daimed:
�I (We) owned ❑ Are buying under contract
GIBSON COUNTY AUDITOR
' Have a benefidal interest in the entity that is liable for the properry Wxes on Ne property and that owns the property or is buying under a conUaU.
If buying on conVad, Fee Simple ownefs name
conVaq is remrded
Parcel number
rwmship
(rJry, rown,
Is Ne pmperty in question:
Rewrd number � Page
U� �'/ - O�Z��n - el ///22?�u,»i lU m�' � C�.ew o�oaem ❑ Mobile Homo (I.C. 61J-�
If any porhon of Ne residenUal sWCWre w Ne Wnd not a ing on 1) aae ihat immediatey wrtounds that sWCture is used b produce inmme, desaibe the uu and portion
or the properry util'aea tn produce f�ome. G
�x� 3 U�� �
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�°"��.''�`rr.�����.��,".�iai�'�;�;�?�„'���sTnraoaRti:oenucnoN•auowarfcE"�`�;�TT�"":u- �,�- �_-�,�;. � • .. ;� �
_.._ _ ._ . ..;-v.vr`�1n �7�a..s.�as�T:-,�..,n'�.���.��. �.:."
20_Pay20_
Lesserof 1/2 Homestead b
VauaUOn a 535.000
Signatura of Auddw � Date signed