Homestead_Shafer (2) STATE FORM 53560(R.3/8-10 TREASURER FORM TS-IA
• APPROVED RV STATE BOARD OF ACCOUNTS.X0, PRESCRIBED BY T1E nEF.M1MESi OF LOCAL GOVER ME\TFLYAVLE lebl.l-nal
Gibson County Auditor J 1b1PORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
_ • Princeton, IN 47670 more beneficial,there is more incentive than ever 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
. . F I - benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
Lr filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
/L'N Local Government Finance will use this information to create tools that.will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION .
— JUL 2 0 .2011 Taxpayer Name Location Address
-Shafer,Shafer, Scott A/Kimberly B '
C-On (t—1 100 N
GIBSON COUNTY AUDITOR PRINCETON IN 47670
2176
Scott A/Kimberly BShafer o Ill 111-11111111 111IIIflu III fi10111111l111111 iIIfffill i1I
. 4014E100N
Princeton IN 47670-8949 - -
III'I'IIIIII'III'II11I"Il1ll"ll'I'IIIIIII1IIII11IIlE11l31lllltl State Parcel Number3 Legal Description
26-12-02-200-001.452-004 /PT SW NE 2 2 10 1.00 AC
S
-
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.
.t r _ , TAC'A 'ER NjOR\IATION , 1. .r i - c
First Middle �� Last
&tI4 r4 , .
' Mailing Address(number and street,city,state,and ZIP code) ID Same as property address
you/ C- goo N u P�ecac�� za-r /N 4f7/?b
Spouse First - - Middle Last
OM' ''.Le-19 B ws iCa&.
Mailing Address(Number and street,city,state.and ZIP code) ® Same as property address
.yo1 L 5 lob Al . I h 11\1 `174 D r .
-
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 homesteadstandard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully, i- or she may be liable i back taxes and substantial financial penalties.•
Owner I Signa ' Date
CLAIM FOR HOMESTEAD PROPERTY TAX
e CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
C� _ ..
1�OR� '
APR 16 1999
YEAR
� 1 � --c /� earth@ *4Ae1KTY AUDITOR
Ma 1
I (We) �—�J ��ei�� a 1st day of March, 19
1 (We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
i I I (We) owned ❑ Are buying under contract
ave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
_ _ _ CONTRACTRECORDED -. -
It buying on contract. Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION
County
Township -
T in district (city fawn, to ship) -
Parcel nu ber -
(1)
Legal descr ti
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surro nds that structure is used to produce income, describe the use and portion
o( the property utilized to produce income.
_oa -ao
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County Township
I hereby certify the above statements are true, correct and complete.
S' nature of claimant
(1)
Signature of Auditor Date signed
'
number and street city, state, ZIP code)
U
,. C
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
+ NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Signature of Auditor Date signed
'
Otherland
(2)
Total land (line i plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6) -
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pl/s line 7)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000
S
Signature of Auditor Date signed