Homestead_Basham •
',Mr rr*M!J!M,II'/5 I tAFASURLA FORM IS-IA
I IPORTANT NOTICE TO DFMRTMEIT OF LOCAL
PROPERTY ROWNERS
Gibson County Auditor
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes a
more beneficial,there is more incenmx than nor for homestead frami homestead fraud causes higher tax bills for all:therefore.
• REA 1344-2009 requires taxpayers who receive the homestead standard deduction to verity that they am eligible to reecho the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county official,.The Depanntent of
N.) Local Government Finance will use this information to create touts that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
V r Taxpayer Name Property Address
VW Basham, Daniel Ray
PP tc ` / 1 117 S Prince ST
1^ --�� n�7'�'(.�y/ vX Princeton IN 47670
Daniel Ray B �GOVN pk D1Spa
1117 SRI
m State Parcel Number Legal Description
PRINCETON IN 47670-3011
ItItrllrrtltllrtlFrrillrtttrlltll IltttlltttllltttlttllFl $ 26-12-18-102-000.106-028 019-00106-00 SS ADD 27/28
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 INFORMATION
Owner I First Middle Last
Deal- L Ray sHeirt
tg Address(number and sheet.city,state,and ZIP code) lA Same as property address
tse First Middle Last
Mailing Address(Number and street,city,state,and'LIP code) ❑Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please slvcify in Part 4 below)
slate ._ _
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 may be liable for back taxes and substantial financial penalties.
Ours orate �i Date
III
CLAIM FOR HOMESTEAD PROPERTY TAX
- � CREDIT/STANDARD DEDUCTION
` State Fartn 5473 (RB 17-07)
/
Preunbed by Ihe DepartmeM af Local Govemmenl F'vance
INSTRUCTIONS: See reverse side /or filing ins6uc6ons.
�,oR YEAR
� €�C�o
DEC 2 6 2�08
� M'e) aCUC1/n.�-e.� �. • Y��--� '«.., ,.,'.-
certiry tha on th�7st day nMaprch. 20
1(We) omipied as our prindpal place of residence the fdbwing described real property (or which a Homeste�f�pAit��e'C�eili��rtereliyRdaimed:
��I (We) owned ❑ Are buying under contrad
Have a benefidal interest in the entity ihat is liable fw the property t�es on the property and that owns the property or is buying under a contraG.
11 byvi9 on canUap, Fee Simple ownefa �ma
RBCOfdCis O}6C9 wh0le COf1U2d i5 rBCptlBd
counry
Parcd number
TamsWp
Legal
Ii arry portion of Ure residerNal stnicWre or Ue la
d �he pruperty ulilized b pmdute income.
a/� -�a -/SD9�D�o.
1
> D U a�
nd ezceeding one (1) acre
�o� - O�-b�
Recortl number
(c4y, town.
Page
�� I Is Ne property in quesiipn:
❑ Real property ❑ Mobile Home (/C 6-1.1-n
immediately wrtounds Ihat sUUCture is used lo pmduce inmme, describe Ihe use and pwtion
.- .
, . .. . .
„.
LarM not exceedrg 7 (o/re) acre immediately '' '���:' �;•`���,r"� �_"'• - - -
re -
surrounding residential improvements_ (�) -- "'` :.*.�^�"'`:�.;'� " ., .�V?�,, �.
Oiher lard (2� .�, ` _ ? :' - -
,: ; ,'�'
Ttlal land (line 1 plus line 2) (g)
� .
� » �
ResidentialimprovemenLsorMnualy �Ilirg (4) _ -�:•`'tw-,.;..
PSSESSEd:'iObI�B / �.�2fiUfdCQIfEd iiIXf12 - k .-�.: � � .
Gara9e (5) ' --..^ _ '
Other improvements (6) . . .�. -.
Tctal improvements (line 4 through line 6) (7�
Tcfal value (line 3 p4a Grre n (g�
I hE2by tertiTy fhe ebove is true, cOrtCtt, and SignaWre of Asse�sw Dale signed (month, day, yea�
complete.
Vaifying action - SlgnaWra MAUditw Date signed (month, day. yea�
� . �.-� � � • •
�Y ZQ — 45.000 for 2007 pay 2008 42.000 for 207 0 pay 2011
Lesser W 12 qq ppp for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation S
« 43,000 for 2009 pay 2070 40,000 payable after 2012
SignaWra of fwditor Dale signed (month, daY.Y��J