Homestead_Collins 13
SIVE'OtM vn t,C1'4PO rwASmUR PORN fl-IA
APPRO.ED BY STMT.BOARD OF x'tSRr.Ta.Zan pars tam or mr DEPARIVEir OF EO�S1 novoorMrl.T FNAScE te Vt.1r4.t
Gibson County Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
Y'a more beneficial,there is more incentive than exec for homestead fraud.I lomestead fraud causes higher tax bills for all:therefore.
HEA 1343-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kepi confidential and can only be accessed by authorized county officials.The Depanment of
Local Government Finance will use this information to create toots that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address _
Collins, Angela K a'a * S c\5O R
ttv t t 0 I`mot 1- LO
1802 (c ,LF t
Angela K Collins °�
2284 S 950E State Parcel Number Legal Description
OAKLAND CITY IN 47660-8442
lI�nllnlltllnrlluilnllnln1u1t1r r1n1r11n1n1n11r ll11 26-13-23-300-000.423-006 003-00423-00 PT SW SW 232-92 AC
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.
PART 2:TAXPAYER INFORMATION
Owner I First Middle last
s( I oyadlr\5
tg Address(nu and strut,city,state,and ZIP code) �nme as property address
A a * el 50 DADA (b I LEI (_e LZ
Spouse First Middle Last
Mailing Address(Number and street,city,stale,and ZIP code) []Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number past 5 digits) Other(please specify in Part 4 below)
__ _ _ _
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.
Ow r Signature (� ^��
)
PART 4:ADDITIONAL INFORMATION
I
I
CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
CREDIT /STANDARD DEDUCTION
` State Form 5473 (R8 / 7 -07)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions. NOV 0 3 2008
I (We) cer6 t��gaSt QnNthe Q�tNd�aVV opf'Xarcch,p20_
I (We) occupied a ur principal place of residence the following described real property for which a Homestead Property �a�CrBtlit i5 tteT�b�tlaimed
aI (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.
MINEMIZT-MI ••. .
If buying on contract, Fee Simple ownees name
where contract is recorded
County
Im
Parcel number
Tax ng
the
If an n of the residential structure or the land not exceeding one (1) acre that imgrepjajNy surrounds that
of th #9 r y utilized to produce income.
`300.000.30 G
Record number I Page
Real property ❑ Mobile Home (IC 6- 1.1 -7)
ire is used to produce income, describe the use and portion
b_pay 20_
Lesser of 112
Homestead Valuation
or
Signature of Auditor
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012 $
43,000 for 2009 pay 2010 40,000 payable after 2012
Date signed (month, day, year)
'
Comm
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
' s
Garage
(5)
Other improvements
(6)
Total improvements (fine 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is We, correct, and
Signature of Assessor
Date signed (month, day, year)
complete.
Verifying anon - Signature of Auditor
Date signed (month, day. year)
b_pay 20_
Lesser of 112
Homestead Valuation
or
Signature of Auditor
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012 $
43,000 for 2009 pay 2010 40,000 payable after 2012
Date signed (month, day, year)