Homestead_Barrett SLATE FORM!)v+11e/Nw1 TREASURER FORM TS-IA
APFRt EO BY ST■TE IOSRDOr WYR:NTc.1.w " rtr]C4.mm BY 111E DEPARTMENT OF LOCAL famR:01Ra FINANCE IC 6.1.1-124.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
i more beneficial,there is more incentive than e'er for homestead fraud homestead fraud causes higher tax bills for all:therefore.
yp 't HEA 1343-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe the
benefit and to provide additional identifying information nemsan'to allow county government to better monitor homestead
jt I filings.This information will he Leo confdetuial and can only be accessed by authorized county officials.The Ikpann ent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead baud.
APR 1 2 LULU PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
7703 g t Barrett, Brett A
GIBSON COUNTY AUDITOR /
R4 Box 123
//J_�( Princeton IN 47670
403
Brett A Barrett
208 N 3rd Ave State Parcel Number Lezal Description
PRINCETON IN 47670-1012
1111111111111111111111111 S 26-11.12.104-000.572-028 019-00572-00 TOWER HGTS 83/84
III.JindJ1111nr111 /III
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.
PART 2:TAXPAYER JNFOR%IATION
Owner I First Middle Last
QR 1T1 AL_Poi QPsVeb-v 1
re Address(number d street,city,state,and ZIP c'oddee) Same as property address
aC � Q J s� b g V e
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
Sort
PART 3:CERTIFICATION - • T --T- —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
unlawfidly,he or she may be liable for back taxes and substantial financial penalties.
Owner 1 $iglml �y Date
�, CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
� Slate Form 5473 (RB 14-03)
Prescnbed by (he Departmenl of Lacal Govemment Finance
INSTRUCTIONS: See reverse side /or liling insfructians.
�� ^ i�\J
� � FORM. _., `L YEAR
HC10 �
n � u i � 01101
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I(We) V1,/�/L+6 /�/ `�-�- �/�J//[ �i�// � certify that on the 1sl day of March, 20
I(We) upied as our principal place of res�dence Ihe following described real propeRy (or which a Homestead Property Tac Credit is hereby daimed: �
I(We) owned ❑ Are buying under contract
` Have a benefidal interest in the enlity thal is liable (or ihe property taxes on the property and that owns the property or is buying under a conVaU.
If byv�g on conVact, Fee Simple ownefs name
Remrtlers offica where conVad is
Counry
Tamship
Legal description
vi �- u�� i�� ��
H any portion of Ne residenUal sW cW re a Ne land not
of the property util¢ed te produca inmme.
0
acre Nal immediately
Record number � Paqe
Is the properry i�sUon:
� eal propeRy ❑ Mobila Homo (/.C. 61.7-n
iunds that swcture is used W produca income, desuibe 1he use and portion
�� '��'•'�`�'�`�i;:a.iO�� j ..s� .. .. . . .. 2, . r
s �� 'ASSESSOR�USEONLY� v��g�� ��UET� zzv4 �ASSESSED�VALUE � �HOMESTEAD� � NON=RESIDEIJTIAL'`'��
�,, -*a,�i�^,5.k y;}�:°„�;,,,��t. � ,�. �-.�VALUEX�,�t.;� _.AT�100Yo'OF�TTV� �;VALUE� �.'�i.,�i��'yVM.UE��,?`�t,.�v�-�r,
Land not exceeding 1(one) acre immediately (' �� ��t�i�'3 �i�},°��
surrounding residential improvements. � ������s��.�!-,;����-,'
Otherland (Z) AR� �,�
Total land (line 1 plus line 2) (3)
+�'.r' h'F,.i7�r �-�s+�:�
Dwellin �"'� � `��
9 (4) �sa�.�.�a'�t�<�� �"�v ��'-.�.i.�3� �
Residential improvements or Mnua�y u
Assessed Mobile / ManufacYUred Home Garage (5) ��5i' _ �' � �:;,�� �
� *.�-�' ,�_ ¢�.�"- ae:a. a,�
Other improvemeNS (6) '� �
� ,'�..::._
Tdal improvemenLS (line 4 fhrough line 6) (�)
Tdal value (line 3 plus line n (8)
I hereby certify the above is irue, corred, and Signature o�t�sseswr Date signed
complete.
Vrritying aclion - Signamre oflwdiror Date sgned
2Qf�Pay20C1 ]
Lesser of t/2 Homestead
vauauan or 535.000
5
Audito= / '�J ll�� IDa�s��e/
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