Homestead_Ross (4) „ _ .
FORM BY,T01-MNMI T FINV:rn FORM TS-IA
.VPRtn'En BY CTVY MUM)OF 3M1me:irly,n PPSS[TIAm AY THE UEPMTNLYTOFL(4AL[]n20.W.ntriN'.LCCEMH.1_A,I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead Aandard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayer who receive the homestead standard deduction to verily that they are eligible to reethe the
benefit and to provide additional identifying information necessary to allow county goverment to better monitor homestead
filings.This infomation will be kept confidential and can only R accessed by authorized county officials.The pepanment of
local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Ross, James D
112\V Pinkney
Princeton IN 47670
2970
James D Ross
112 W Pinkney St State Parcel Number LeEal Description
PRINCETON IN 47670-2456
26-12-07-304-003.682-028 019-03682-00 SOUTHWARK ADD6PT/11
t o II uIt II n I nIII r Ir Is I il't I r I u II II u t I t II uiI
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
ilkAddress(number and street.city, • te,and ZIP code) - E.'ame as property address . -. _
l� 1S . rR\Lr��tLSt P- P I�r\c-'P4-? . ft.9 47CQ 7i9
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Dricds License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Sox
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.
• er I Signature Date r((��
e•�•'+
d'� a CLAIM FOR HOMESTEAD PROPERTY TAX '
x��'= CREDIT/STANDARD DEDUCTION
�` � State Form 5473 (R2 / 5-92)
uu . . .-
� INSTRUCTIONS: See �everse side /or filing instrucfions.
t��s�t `I 5 �'�
G
, 11
I(We) ��,(/�/�—�!i `/_� certi�lFat on jt�@ �`C,dN§`d( M�M.49 '
,....,
1(We) occ i d as our principal place of residence the following describ al property for which a Homestead Property Tau Credit is hereby Gaimed:
�We) owned ❑ �Are buying under contract . , . , �
ave a beneficial inieres� in the entity ihat is liable tor ihe property taxes on the property and ihai owns the property or is buying under a contract.
- � � � -� - . CONTRACT�RECORDED � � � . - �
It buying on contracL Fee Simple owner's name - .� . � . ' �
+"iE "
Fecorder's oRice where contract is recorded Record number Page
� ` • PROPERTY DESCRIPTION � � �
Counry � Township . 7a<ing district (ciry. lawn, township) ".
Parcel num er legal description
- b�ac� � �
It any portion of ihe residential simcture or �he land not exceetling one ( � acre that immediatery wrtounds ihat swcture is used ro produce income, describe ihe use and portion
of ihe property u6lized to produce intome.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Counry Township Couniy Township
I hereby certify the above statements are irue. wrrect and complete. Si9n ture or ci �mam
�ss (number and street. 6ry, state, ZIP wde) [%
r ` . '
s.N lt.�
ASSESSOR USE ONLY TFUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VAIUE VALUE VALUE
Land noi exceeding 7(one) acre immediatety �
surrounding residential improvements. (�) '
Otherland _ (p�
Total land Qine 7 plus line 2� (3)
Dwelling (4)
Residential improvements
Garage (g)
Other improvemenis (6)
Total improvements (line 4 through line � (7)
�value (line 3 p�s line � (g)
����dereby certify ihe above is true, correct, and Signamre of Assessor Date signed
complete. -
Verityirg aaion - Signawre oi Autlitor Date signed
79_Pay�9_
Lesser of 1/2 Homestead
' �.fi• —, - � `
.
. STANDARD DEDUCTION
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