Homestead_Parker (9) -, • -F STATE FORM 53564(53/IWO) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.NM PRESCRIBED BY 111E OEPARTMET OF LOCAL GOMM/EVE FINANCE IC 6-11324.1
Gibson County Auditor IMPORTANT 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,
IP HEA 13442009 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 government to better monitor homestead
-� ngs.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
� al Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART l: PROPERTY INFOIL\IATION
APR 1 1 2011 Taxpayer Name Location Address
_ . - Parker, Jerry L/ Pamela A
C 811 W BROADWAY
1. - GIBSON COUNTY AUDITOR PRINCETON IN
1762
Jerry L I Pamela A Parker 11111111_DI10 011101 DIII 011010110110111101111 1101111110111. 111 II011011]I01111 III
811 W Broadway
Princeton IN 47670-2011
IIIIIIIII' 'ItttItIIIIIItIIIllllltIItlll"IIIIIIIII'll'llll'I1II1 State Parcel Number Legal Description
26-11-12-400-703.875-028✓BLDG ON LSD GRD it
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.
__. __JART_2_TAXPAYER INFORNIATION__ _ _
Owner I First Middle Last
Serr�� L- PA-R, /?-e r
Mailing Address(number d sued,city,state,and ZIP code) ❑ Same as property address
q1I cA ) c )r0rtCPWC( Pry) c� 4on =N . y7 L7 0
' Spouse First Middle / Last
it/4- /VA 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 Part 4 below)
I I I I I I I I I State
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) ignanne Date
, CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
t / Slate Form 5473 (R6/403)
Presfiibed by the Department of Local Govemmem Finance
INSTRUCTIONS: See reversc side loililing inslnic(ions.
FORM
HC10
YEAR
I(N/e) certT i� aTt .on the 1 st day of March, 20_
I(We) occu i as our p' pal place of residence Ihe following described real property (or which a Nomest� d'Property,Tmc Cretlit`is hereby daimed:
❑ I (VJe) owned ❑ !ve buying under contract � � { ,}
, Have a benefidal interest in the entity ihat is liable for �he property taxes on the property and that owns the pmperty or is buyfng un e�contraU.
Counry
Toxnship
Legal
H any portion of Ne residmtial strudure w �he land
ot Ne properry utilized to produca income.
a�xe that
Taing dislrict (riry, fown, township)
9 Is e vroperry in question:
S❑ Real property ❑ Mabiie Hwno (I.C. 61./-�
wnounds that swcture is used to produce income. describe Ne use and portion
20 _ Pay 20 _
Lesser of 1/2 Homestead
vaivaLOn a E35.W0
of lwditw
3
�