Homestead_Gordon (4) STATE FORM MO(R)111-10) TREASURER FORM TS-IA O
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED oT THE DEPARTMENT OF IO(ALCATTANMENT FLYAV IC 6-1.1-22-6.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY O\YNERS
101 N. Main Steet 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 1344-2019 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
FIL' benefit and to provide additional identifying information necessary beam-to allow county government to beam- monitor homestead
•lings.This information will be kept confidential and can only he accessed by authorized county officials.The Depareneot of
rn
Govement Finance will use this information to create tools that will help county officials eliminate homestead fraud.
I PART l: PROPERTY INFORMATION
MAY 6' 2011 Taxpayer Name Location Address
Gordon, George H/Sheena
608 E Walnut
`N. Princeton IN 47670
2735 GIBSON COUNTY AUDITOR
George H/Sheena Gordon III 1I1�1 111_m1111111
C/O Sheena Gordon II_ II �III�IDII�I I IIDII -
III QII�I�I I IDII I��IIDIIDIDII I�III
608 E Walnut "
Princeton IN 47670-1772
Illllllrll��llll 1111I1I1tl1i1ill1i1llt'lill'1i11'I'i"1111'1 State Parcel Number Legal Description
26-12-07-202-001.928-028 /NS LOT 2 PT R4
- 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
• Ow _ I First °Middle _ Last
Sheehy 0iave GOrdoi,
Mailing Address(number and street,city,state,and ZIP code) m Same as property address
bn8 E. RialnMf 5±/ Vrinctiar, �7la 7o
Spou First Middle Last
Nat
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)
1 1 1 1 I I I l I stoic
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.
a• .-'I Signature Date
\' _ / _�
e� "�� a CLAIM FOR HOMESTEAD PROPERTY TAX --
i��': CREDIT/STANDARD DEDUCTION
,�,�;� State Porm 5473 (R2 / 5-92)
Vii
INSTRUCTIONS: See reverse side far /iling insfructions.
. . ^ 1-� -__- -- � `
FORM VEAR
H�,o � 3
I(We)��17 �Q,��/��� ��"s'�LSUC,I_) �� certify th��i� 1 t ���chJdl9_
�"e)pecupied as o principal place of residence ihe following described real property tor which a Homestead Pro rty x re i is eieo�laimed
owned ❑ Are buying undercontract ppR 2 g too�
� � J...�
� a beneficial interest in ihe entity thai is liable for the propeny taxes on the property and that owns the property or is buying under a contract.
CONTRACT RECORDED
If buying on contract, Fee Simple owner's name
Fecorder's oflice where contract is recordetl
- - " PROPERTY DESCRIPTION
County Township . Tazing district (
P�cel m ber O Q Legal description
U
If any portion of ihe residential stmcture or the lantl not ecceeding one (7 � acre that immetliately surmund:
o� Ihe pmpetry NiliZed to prOdUCE inCOme.
Record number Page
used to produce ir�come, descnbe Ne use and portion
PROPERTY OWNED BV CLAIMANT IN OTHER COUNTIES
TownShip Counry
� c0rtify ihe above Sialemenl5 are [rue, CorreCt and Complete. Signa f claimant
(numberand�reeCSiry,;jare,ZlPcod� , � � � � . y
� � ASSESSOR USE ONLY
Land not exceeding t(one) acre immediatety
surrounding residentiai improvements.
Oiherland
Total land (line 1 plus line 2�
Dwelling
Resideniial improvements
Garage
Oiher improvements
Total improvemenis (line 4 fhrough line �
Total value (line 3 p�s line 7�
I hereby certify the above is true, correct, and
complete.
�binn action - Sianature o� Audilor
��� 19_Pay19_
Lesser of V2 Homestead
� r� Valuation or 52.000
TRUE TAX
VALUE
(�)
(2)
(3)
(4)
(5)
(6)
1�)
IeI
Signature ofASSessor
S
ASSESSED
VALUE
AILOWANCE
MOMESTEAD I NON-RESIDENTIAL
VALUE VALUE
Date signetl
Date signed
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