Homestead_Stoll MATE IORM!IN.1R/fwd TREASURE(FORM:11A
APPROVED BYAt\TE BOARD M'M`M1BLNTY'u PICIZMiamaY n1r DEPARTMENTO fLIX'AL rovrnlMrNT FINANCE lc•1.1-2:4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS •PRINCETON IN 47670 Individuals and married couples are limited to one homestead sandal deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ma for homestead fraud.Homestead fraud causes higher in 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 goverment to better monitor homestead
filings.This information will be kept confidential and can only h accessed by authorized county officials.The 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
-- Stoll, Thomas S/Robin L
R I R I T
Haubstadt IN 47639-9750
9568
Thomas S/Robin L Stoll
12796 S Sunset Dr State Parcel Number Legal Description
Haubstadt IN 47639-8672
Itfll'IIIIIIIIItttllllllitlttll lllltll ti Iii Ill':Intl'tlltl111-- _26-22-14-300-001.655-024 COUNTRY VIEW EST 8 D-2
PART 2:TAXPAYER INFORMATION
'Owner I First I Middle a Last
AOmaS SCO'I-t" S+O/I
',Tg Address(number and street,city,state,and ZIP code) 0 Same as property oddness - — - — _
1 cib, S. 5(An sed' Q/\ • P-RlvbsVadl I1N 7Lo
Spouse First Middle �� Last
Rabin LL nn
Mailing Address(Number and steel,city,stale,and ZIP code) 0 Same as property address
lam 5. SwAsed" 6f\.� Np S`fad� / T N q7&3 9 .
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 s s. m e la r back taxes and substantial financial penalties.
Owner I Sigrnanyr Da�—tr-----_
I •
� CLAIM FOR HOMESTEAD PROPERTY TAX
i> CREDIT/STANDARD DEDUCTION
,�` • State Form Sa73 (R2 / 5-92)
,.,.
INSTRUCTIONS: See reverse side Ior liling instructions.
�o
��'�
FORM YEAp
HC10
. -. . . � .. . -%iCERTIFi TION STA MENT'. �. ..... ,'. � . � - - - - -
I(We) � certify that on [he 1st day of March, 79_
��e) pied as our principal place of residence the tollowing described real property for which a Homestead Properry Tax Credit is hereby daimed:
I (We) owned ❑ Are 6uying under contrad
❑ Have a bene(icial interest in the entiry ihat is liable for the property taxes on the property and that owns ihe property or is buying under a contract.
- � � - ., . .. CONTRACT RECORDED_. ..-_ � , . � r �•' . -. � . _ � _ � � . ' `� _: .. a,:; . .
If bryirg om m�tract, Fee Simple owner's name
Recordels office where comraa is recortled Record numher Page
� � � ' � ° -PROPERTY �ESCRIPi70N °
Counry Township Taring tlisirict (ury. town. 1
Par el mber Legal tlescription •
b - s D
Ii any ponion of Ihe resWential stmaure or Ihe land not exceeding one (1) acre ihai immediately o ds that struct
oi Ne properry utilized to produce income.
P/arl�lii
�
SiN
i
:.' �� - x::.. -,:' •.�.f'.�... .
used to produce income, describe the use and poRion
� - PROPERTY OWNED BY CLAIAtANT IN OTNER COUHT7ES �
Counry Township Counry 7ownship
\
�reby cenify ihe above statemenis are true, correct and complete. 5� re f aimam
I
Address (num6eraiMStreet ciry, sta(e, ZlPpode)
� 476
ASSESSOR USE ONLY �UE TAX ASSESSEO HOMESTEAD NON-RESIDENTIAL -
� � � - -� VALUE � VALUE YALUE � VALUE . �
Land not exceeding 1(one) acre immediately . ��
surrounding residential improvements. (�) - - � °" -
Otherland (2) '
'4� •
Total land (line 7 plus line 2� (3)
Owelling (a) � � ' �
Residential improvements
Garage (5) " .
Oiher improvements (6) -
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line � (g)
I hereby Certify Ihe above is irue, Corrett. and Signature of Assessor Date siqned
complete.
�fyirq aaion - SgnaWre of Auditor Dare signed
" - � STANDARD DEDIJCTION ALLOWANCE" . ��i%, , ..
79_Pay19_
Lesser of 1/2 Homesiead
Valuation or 52,000 S
Si9nature ol Auditor Date signed
' _ �i�_ . �_ a...