Homestead_Strickland (6) STATE FORM 53569(R21-09) TREASURER FORM TS-IAI
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE 105.1.1.22-8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS • .o
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
deduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
Oauses higher tax bills for all; therefore, HEA 1344-2099 requires taxpayers who receive the homestead
s andard 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.
• PAR : PROPERTY MA ION -
Taxoaser Name Propery Address State Parcel Number Leta!Description:
West
Amye J Strickland 822 X 26-12-07-102-003.031-028 019-03031-00 FOREST PARK 39
Princeton IN 47670
Complete and return to:
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
- PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
•� , .k 52an Shr � GC I ay, c-4
Mattmg Address(number and street.ply.Mate and ZIP code)
Same as prope+bY address
Mailing Address(number and streeL Ply,state and ZIP code) I V Same as property address
Soda sewdy Number(last 5 digits) Drivers License State ID Number(last 5 digits) state 1 Other(please specify in Pan 4 below)
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
. ( )
PART 4: ADDITIONAL. INFORMATION •
• .
•
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Slsle Form 5/73 (R6 / 4-03)
Prewibed by ihe Departrnem of Locel Govemment Finance
INSTRUCTiONS: See ieverse side /or filing insfn�ctions,
��. ��r� .
4 FORM � YEAR
C� HC10
' M'e> --��` -�-�L�'1���� ' � `. ' " y ���, � 9 2U Yb
certi e 1st da o( March, 20
1(1Ne) occupied as ou nci al place of residence the following described real property (or which a Homestead Property Tac Credit is hereby daimed:
� I(We) owned �Are buying under conlract ��'�y ��•
U en lTOR
Have a benefidal interest in the entity that is liable for the property taxes on the property and tliat owns �o,�� ilis b�iying �inder a conVaU.
If buy'ug on conVaq. Fee Simple ownefs name
Remrdels ofice where coniraU is
Counry
H any ponion of Ne residenllal sW cWre w
ot the property uWBed to produce income.
County
7�nship
land not exceetling one
To.vnship
Record number � Page
Ihe pmperty in que5tion:
� Real properry ❑ MoWle Homo (I.C. bf. f-n .
ave thal immediatety surtounds tha� £vucWre is used to produce income, desaiba Ne use and poNon
I hereby certify lhe above sta�ements are We, corteG and complete.
and sJreet ciry, state,
ol
Township
�` �'.?^ i' S ':�.�e�. �.+'Y' . _ �� .3�J.� F �`ar.'.� .�✓y �'SF . y. .. � . � _ . � . .
�'�'t��A5SES5DRUSEONLY '�����iTRUETAX�`F-iz ASSESSEDVAL'UE�HOlAESTEAD�` �`,NON-RESIOENTIAL }
�$"a?' .t� '.,'x'.,.i? f�'.�i�'�sr 3�4 ��VALl1E�,"{ljtt � AT-100%OF,fTTY �"-�'T�'"VALU��w� ���i�1:�.�s.VALUE`�'wk?'a��
Land not exceeding 7(one) aae immediatety �r3 i, ,y � ec :� " g
surtounding residenfial improvemenLS. (�) �� � r'. 5��,�"��;
�c,.�£`�' i:
Other land (z� ?�.-�. �`
: ���
Tdal land (line 1 plus line 2) (3�
��.�c,° 7 r�� qy�.
'y!�V f ~ '1..� ' rl:fy;q� ry^e
�We��l�9 (4� �4��: . �� ~Y
�Residential improvemenLS or Mnually %�'�` � °'`��'' �' '
Assessed Modle / ManufacNred Home Garege (5) :�£�L}���`�'�'•�"t�+��i�'i�ti
� l�x��F''�i�si.'�i.'�!'_.-f"g-fd�
iS::�'��.�J..- N }
Otherimprovements (6) �.»o,,���i��z_-`� s
t�=aa-�:Y:tt �s..
Tatal improvements (line 4 fhrough line 6) (�)
Tdal value (line 3 plus line � (g)
I hereby ceAify the above is We, carreG, and Signawre o�nssessor oate signed
complete.
Veri(ying action - Sgnature af Autlitor Date signed
..•.�':�����'�t"�.°m�?�..��s?7?<�4���-°?ls:�--�STAN DARU;DED UCTION'ALLOWANCE +��'�'g"�L�:�.'�zt�'�s.�"�`.�",��:y��Y�9�si_'+"„:
20 _ Pay 20 _
Lesser W 1/2 Homestead
Ve�uaLOn w 535.000 5
Signature of Auditor � Date signed