Homestead_Poe0 CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION
State Form 5473 (R8 r 7 -07) HC 10
Prescribed by the Department of Local Government Finance 1
MAY 0 4 2009
INSTRUCTIONS: See reverse side for filing instructions. ML
TiN STATE
CERTIFIcA I (We) t° S c i ! a ��p • GIB80N COUNTY AUPIat on the 1st day of March, 20_
I (We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
1 (We) 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 under a contract.
CONTRACT • - s s
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
County //"'++
b l9' on
PROPERTY
Ta 'sfup //
C,n ?'e/
Taxing district (city, town, township)
��4nCj(
Parcel number
Legal description
Is the property in question:
,96-13-17—?og —0,clik-7-190C
I
❑ Real property ❑ Mobile Home (IC 6-1.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately sunounds that structure is used to produce Income, describe the use and portion
of the property utilized to produce income.
ASSESSOR
ASSESSED
• s
AT rr•, OF
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements or Annually
Dwelling
(4)
-
Assessed Mobile / Manufactured Home
Garage
(5)
tit. 3
Other improvements
(6)
Total improvements (line 4 through Gne 6)
(7)
Total value (line 3 plus line 7)
(8)
1 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)
-M _ pay 20
Lesser of 12
Homestead Valuation
or
1'
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012 S
43,000 for 2009 pay 2010 40,000 payable after 2012
STATE FORM 53569(R3rs-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE 106-I.1-22-8 I
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS x yN
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
r
seduction 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 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 filings. This information
will be kept confidential and can only be accessed by authorized county officials. The Department of Local
Government Finance will use this information to create tools that will help county officials eliminate
homestead fraud.
t " PARTI: PROPERTY-INFORMATION r o
Taunter Nam{ property Address State Parcel Number Leal Descrioliont
Jessica Poe Etal 406 E ROOD ST 26-13-17-303-000.357-005 PT SW SW 17 2 9 .8488 AC
FRANCSICO IN 47649
Complete and return to: - umiiniti11p1111 lIfflm�D!1pp m®Inlnhrpnnngn!nrnlnlnl
iiasSlllild Dllnung431UU®iti t01nll71U1flu191aiin ILUnWl
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
•PART 2: TAXPAYER INFORMATION ,' -47
Owner I Furst Middle last
LSe S`l Q f m a., e P��
Mailing Address(number and street,city,state and ZIP code)
V/ Same as property address
110 (0 E. la)mcl St_ FCnncts 417 ( YR
spouse First Middle Last
Mailing Address(number and street,city.state and ZIP code) `-A 17 Same as property address
gbto r_.
L4 sf-. -Rn r c; c o , -L-, . 2-171 t,c1 q
_:
-. . ,. . vas
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
NOV 1.5 2012
GIBSON COUNTY AUDITOR