Homestead_Jenkins (2)CLAIM FOR HOMESTEAD PROPERTY TAX yy \ FORM YEAR
CREDIT /STANDARD DEDUCTION ` HC70
Stan Form 54th (R817-07) Department F 1 ')q"
� ,. `
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) ce at on the 1 st day of March, 20_
'I( (We) occupied as our principal place of residen a following described real property for which a Hors ad Operty Tax Credit is hereby claimed:
I (We) owned ❑ Are buying under contract
GIBSON COUNTY AUDITOR
❑ Have 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.
CONTRACT ••D
If trying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
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ASSESSOR •
PROPERTY
Tomship
Taxing district (lay to shi i
el number
Legal description
Is the property in question:
c�- i3- ac) (a -OCi� i
Real property ❑ Mobile Home (IC 6-1.1 -7)
If eh portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that re is used to produce Income, descdbe the use and portion
of h%
the property utilized to produce income.
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ASSESSOR •
r VALUE
HOMESTEAD
NON-RESIDENTIAL
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus fine 2)
(3)
1
Residential improvements or Annually
Dwelling
(4)
5 - -' -�-
Assessed Mobile I Manufactured Home
7sh' -
Garage
(5)
-
Other improvements
(6)
':r ='` Y•-
Total improvements (line 4 through fine 6)
(7)
Total value (line 3 plus fine 7)
(8)
hereby certify the above is true, correct, and
signature of Assessor
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day, year)
20 _ pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser - 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
$
Homestead Valuation
Homeste
43,000 for 2009 pay 2010 40,000 payable after 2012
or
na
ra TjJ
I n — rr
• 'nit FORM 450,01: •.M1 TWASREA PORN 71-1P.
APPROVED Or STMT BOARD OFMTll:is._nn PIE.YA113m BY air.DEPMfl 4T OF LOCAL GOVERNMfra Fn:VyCE ICr.I3124.l
Gibson County Auditor
'101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead vandard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than Beer for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
fill I HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county govemment to better monitor homestead
filings_This information will he kept cnnt:dential and can only be accessed by authorized county officials.The Ikparm ent of
Local Government Finance will use this information to create tools that will help comity officials eliminate homestead thud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Jenkins, Clarence/Dona
` P013ox 145
Francisco IN 47649
4578
Tamela Ann Jenkins
P O Box 145 State Parcel Number Legal Description
FRANCISCO IN 47649-0145
ltltrllrltlrl'rrr lrrllrl lrll Hill'Mil tilttlultlut VIII 26-13-20-101-000.140-005 012-00140-00 SHOP ADD 13 PT
PART 2:TAXPAYER INFORMATION
Owner 1 First Middle `7� Last
�VYIr.IA 4✓}n ye,n vts
/+ ig Address(number and street.city,state,and ZIP code) ❑ Same as property address -- --— - -
i'oBo31tls locP t� - ezrecg . ��n�is�o ,ln/ 4744/5
/-;
Spouse First Middle Last
Mailing Address(Number and street,city,state.and ZIP code) []Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Sue
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.
Owner I Signature Date
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PART 4:ADDITIONAL INFORMATION
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