Homestead_Roberson •_ STATE FORM (Pi 18-10) ■ TREASLRfR
A1 FORM TS-IA
APPROVED BY STATE EMRO OF ACCOUNTS.MM PRESCRIBE)OE T1IEOEPARTMET OF wCALCOvER\MENT FINANCE IC 61.133 41.1
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.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
4 T T benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
E LJ \ filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
�p J.L ,Ly. Local Government Finance will use'this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
MAY 6 2011 Taxpayer Name Location Address
C ne Roberson, Richard D/Rebekah S
1702 EAST BROADWAY
GIBSON COUNTY AUDITOR _ PRINCETON IN 47670
3308 6
II 11 -
Richard D/Rebekah S Roberson I_ III I I I I III II l I��II L111111��II�II I II II�I�I I III I I�III�IL III�II III lII
1702 Broadway ,
Princeton IN 47670
State Parcel Number Legal Description
— ;_ _ 26_12,08-203=003.164-028/DIKE SUB DIV#1 IV PT
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.
---„---_—,_ - -- ____ . -- PAR"[2_TA1PAl'ER INFORMATION - -- -
O . I First Middle - - Last _- __w..-
gic-h a.id - -I 7 e, i Tl d 4 c s e �f
Mailing Address(number and street,city,state,and ZIP code)° Same as property address ,
�) / �f
/742-�. /j /'04AG,/4�/ E% ✓'iv/ ca --7/o,t-. � -, ,- tti'ta- y7C7a
S ” First r\-- Middle -v- Last
ix 4e-`t Mailing Address(Nuum/ber and
//��street,city,state,and ZIP code) /Wame as property address o
7 )a 2 F. gtoa�.f ru_ .°/'!-7 c e 4677- ha/ 0767
PART 3:CERTIFICATION
" 6 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,byclaimingadditional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties. -
I Signature r• Dot/
..•°•�• CLAIM FOR HOMESTEAD PROPERTY.TAX - �
d� q' _
��: -_� : CREDIT/STANDARD DEDUCTION
:� State Form 5473 (R2/1-90) • '
,' '°�• ` INSTRUCTIONS: See reverse side �or �iling instructions.
� O!� ��.
CERTIFICATION STATEMENT
FORM
HC10
7✓
I(We) �ri.a�►_� �- U�4,�-0-�1 i� • certify that on the tst day of March , 19 �
joccupied as our principal place of residence the following described reat property forwhich a Homestead
ro'pzrty Tax Credit is tiereby cleimed: �i�) owned ❑ Are buying under contract
� 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 it under a contract. .. . .
If buying on contract. Fee Simple Owner's Name
Recorder's office where contract is recorded .
Parcel Number � Legal
'RECORDED' '
, Rec<
DESCRIPTION
Taxir'§�i$trfct (City, town, to�
_ �
� � -_I_ �
If any portion of the residential structure or the.land noi exceeding one (1).acre that immediately surrounds that struc-
ture is used to produce income describe the use'and portion of the property utilized to produce income.
� r.,..�a-og� zo3 �0 3: l�4 -�oa� �g� �_
PROPERTY OWNED;BY CLAI
_ Township
certify the above statemenis are'true. correct and
Address (Street. number, city, state
f IN OTHER COUNTIES
nty �
a
ASSESSOR USE ONLY '' � �TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
NON-RESIDENT1Al
VALUE
land not exceeding 1(one) acre immediately ' �
� surrounding residential improvemenis (�)
Other land (2)
Total land - line (7) plus line (2) (3) -
_ Residentiat improvements _ Dwelling (4) . .
Garage (5)
Oiher improvemenis (6)
Total improvements - line (4) through line (6) (7)
7otal value - line (3) plus line (7) (8) •
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
STANDARD DEDUCTION ALLOWANCE
' 1989 Pay 1990 1990 Pay 1991 1991 Pay 7 992 19 — Pay 19 —
Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homesiead
Valuation or $2,500 Valuation or $2,000 Valuation or 51,500 Valuation or �1,500
Signature of Auditor
r-_
�
Date