Homestead_Bartley STATE FORM 53M.IV/a-(rn IAFASUIIA FORM 73-IA
APPROVED HY SHIE a&NRW CIF MCTRsTS.'nu PLtrSMED BY THE DEPMfTSYT OF LOCAL COICERNSITNT MANCE MH.I-:I-II
Gibson County Auditor
101 N Main u IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homes ead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than e'er for homestead fraud llomestead 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 reecho 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 Dcparme n of
local Goverment Finance will use this information to create tools than will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Bartley,Jason W/Amber L
RI .
Oakland City IN 47660
4680
Jason W Bartley
C/O Johnnie Bartley
9832 E SR 64 State Parcel Number Legal Description
OAKLAND CITY IN 47660
26-13-23-100-001.518-006 003-00687-00 PT NW 23 2 9 5.00 AC
C-1
1
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
•Ig Address(number and street city,state,and ZIP code) — --— — Same as property odareslf — ——
963 oZ Erse sfo- Rd 1p/ Oa.-land e 4 �d(afiCL (17ebe
Spouse First Middle Last
, vLbC( ynq gar-F
Ma Hine Address(Number and street,city,state,and ZIP code) Same as properly address
3d Qs&- stay,° Rd (PI D klanc -tr+y, Zhc� (cent (1760v
Each undersigned certifies,under penalty of perjury.that the above and foregoing information is true and correct and that he or she is eliuible 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
•
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5073 (8817 -07)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
f M
• 1 ;, r',a
JiL-
JUN ?• 0 2008
I (nW�,Ie) `� `Y certify that on the C1 s ,O{ 46j mTaj
I `..e) oocu ad as our pnndpal place of residence the following descri a property for which a Homestead Pr6( i�c tiredit is hereby claimed:
'owned ❑ Are buying under contract
l 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.
ONTRACTRECORDE r
Ir b=WV on contract. Fee Simple owner's mine
Recorder's office where conbad is recorded Record number Page
County
Township
Taxi
djitrid y, town, ownship)
Parcel number
a to 3 -a s-/tri -M). sy g_
L al sc'pg n
9
Is the pr in question:
1 1? 0631 property ❑ Mobile Home (IC 61.1 -71
harry portion of die residential structure or thX&nd not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe Ure use and portion
d the property utilized to produce income.
ASSESSOR
— pay 20 — 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation
$
Of 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor
Date signed (month, day. year)
Land not exceeding 1 (one) acre imrediately,
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
_ r.r u Y • "4 - .
Residential improvements or Annually
Assessed Mobile l Manufactured Home
�_:t :•:.;,++. -•
Garage
(5)
a'
Other improvements
(6)
Trial improvements (line 4 through line 6)
(7)
Total value (line 3 plus fine 7)
(8)
1 hereby certify the above is true, oortect, and
Sgnature ofAssessor
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day. year)
STANDARD DEDUCTION
— pay 20 — 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation
$
Of 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor
Date signed (month, day. year)