Homestead_Jamerson�
CLAIM FOR HOMESTEAD RROPERTY TAX
° CREDIT/STANDARD DEDUCTION
t State Fwm 5473 (R6 / d-03) �
' � Presaibed by Ne DeparUnent d LoCal Govemment Flnance
INSTRUCTIONSi See ieverse side lo� filing insfnxtions.
� FORM YEAR
� '
I(VJe) . � V�C/ / /Zertiq�.Hiat on the`tst d�� of, ��20
p �.
I(VJe) occupied as our prindpal of residence the following described real perty tor which a Homestead Property T�c Credit� here aimed:
i� I(VJe) owned ❑ Pre b�ying urMer contract
. GIBSOh COUNTY AUDITOR
Have a benefidal interest in the entity that is liable for Ne property texes on the property and ihat owns ihe property or is buying under a conVact.
on contract, Fea S4nple ownars name
Recotdals oflice whera conuect
Counry
If arry porUon ol Me residential sN
of Me P�PanY ut➢ized W produca
County
Legal
«the IaM rwt exceeding one (t) acre
I hereby certfy the above statements are W e, cortect and complete.
ciry, srare, ZIP oode)
Tadng
bUrtOU�dS
County
Rewrd number � Page
In QuesUan: (/
�Real property ❑ Mobila Hwna (I.C. 67. f-�
W re is used to O�duce Incoma, dasuibe the use and poNOn
��`X''��q+�^+�A SESSORU EONLY�,���^��`��'p TRUETAX� ASSESSEDiVAL'UE �HOMESTEAD� � yNONRE3IDENTIAL� -
�.�� �rEi.`'Y-i�� ,� iL .�i�::,�sl@��.';ti? 'v�`tah � �. ,—, � V/LLUE�p 'AT;100X OF;T.IV . VALUE u, ��_ c.` �FZj�VALUE�.�,`�r� ' '
Lend not exceeding 1(one) acre immediately ;� r .�,� € s'�` q x;-�"� -�
surroundingresidenUa�fmprovemenLS. (�� -.:' ,z� .� ".:=�
� v.
a r
Othef IenE (2� ,r�;i,._�( �`��};Y�
Tatal land (line 1 plus line 2) �g)
''2 A t� Y
Dwe��iii.9 i4i ?:F`3 .s�'`c,A .�Yi,�„i a Y � ' �y, ..}J
Residential improvements or MnuaOy .i;,��� �,,=,�_,�- <�, �.� x�.
Assessed Mobiie / ManufaGUred Home � �,1 �+�._r1 P�.�nr :�;
Garage (5� ...�`' F�.T�*t �'x- -i�'-<
:_ 2s4r�i. ,�.:..w .. `� z._..'`r.;:
�
O�pei improvements (6) , �;;t � �� -
� l..
Tdal improvements (line 4 through liire 6) (7�
Tccal value (line 3 pf�a line n (8)
I hereby certify Ne above is We, cortect, and � Sipnamre otwssessor � Dau signed
completa.- .
Vailying ecUon • SlpnaWre MAudilar � Data signed
20 _ Pay 20 _
Lesser of tf2 Homestead
Valuatlon or 535,000
3
Date
�
_ �� SI�TEl00.M5]Sf9(NJ/610� ' T1lFA5L'RFAiD0.MTSlw
� . �Nllp'EDBYSL,V'E9M0.DOi�(tCDIIVTS,IlO� PIfETC0.�6mBYT@OFP.U(METOFIM�V.Cq�'Q'ME`RfINA`KEK4112:2.1
Gibson County Auditor � � � � � � � � � � � �
101 N. Main Streel �� � �„drv�d�is and married cuuplcs are limi[ed U� one homcctead standard dcduc[ion. Ac the receipt of this deduction 6emmes
Princeton, IN 47670 �
. . morc brncficial, thttc is morc incentire Ihan ntr for homestead Gaud. Hamaitad (rzud wuscs hi�cr lu bills for ell; Iherefore,
- HF'A 134?-?009 reqnires ta<paycrs aiw recei« the homcstead s'andard dcducrion co �erify that they are eligiblc to raenx the
• F I L, E D.� �cfit and to prm�ide additio�l idrntifying infomtation necessary W ellow tmmry gmcmmrnt to bener monitnr homestrad
filings. ltvs mformation uill be tept wn5den[ial and can anly be acccsud by.auiharized counry uf5rials. T6c IXpuLnrnt af
Local Grnemment Fnance w�ill use this infarmation m aeau [aols tha[ will heln counrv af6cials�elimvute homes[ead frud.
_ MAY172011
— C '�.n�
— GIBSON COUNTY AUDITOR
314
Taxaaver Name
Jamerson, Denise/John A
Denise Jamerson II�I
4963 W 100 N
PRINCETON IN 47670-8406
�I�����IIII�II'I'�����'I��III�I����I������I�I��I�1��1��11�11�1���
4963 W 700 N
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PRINCETON IN 47670
ullu II I I� �II� I I� II� II�
State Parcel Number �eaal
26-11-OS-400-000.693-027✓ PTNWSE 5211
D-1-18
�
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the cou
�,,� �
iling Addms (number mid straL ciry, state, and Z[P codc)
'���3
�iai Secvcity N�ber (la5t i digit5) Driva's Licensrl5tat
� ���
h
5 digits) � Drivds
ID N�ber (last 5 digirs)
AC
treasurer.
S �0,2
amcasPmpenyaad�as I.
OtLer (please spxify in Pazt 4'below)
] 5m� (.
iddle
SAr�nE,r x� �
—r7%8�fi2'ai"pmverty adi7ras i
LJ
Other (please specify in Part C� bclow)
undersigned certifies, under penalty of perjury, that the above and foregoing information is we and cortect and that h_ or she is eligible to
+e the homestead standard deducrion on this property. Each undersigned also undersiands that, by clairriing addirional � omestead deductions
+fully, he or she may be liable for back ta�ces and substanual financial penalties.
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