Homestead_Georges I STAVE FORM9W:t' t TREASURER EMU MIA
.APPROVED BY:TOTE Nikko M 4T T..\tc SsM IAnsf,lmED BY lie DEPARTMENT OF LIXaQ: RMMOEN FIANCE M E•r.1-2.4.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRI p. I 4767 ( e Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
' 1 1 „y, l,` more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
11. 1.®get � HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to serif&that they are eligible to reecho the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
MAY7 LULU flinty.This information will he kept conlldemial and can only hr accessed by authorized county officials.The nepanmcm of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
`--yy� y PART 1: PROPERTY INFORMATION
p'fe 4'' Taxpayer Name Pro'ens'Address
ORISON COUNTY AUDITOR Georges, Richard J
.n.City IN 47660
4873
Richard J Georges
711' State Parcel Number Legal Description
OAKLAND CITY IN 47660
26-13-34-200-001.346-006 00301346-00 PT SW NE 34 2 9 2.50 AC
C-1D-6
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
_ �� °� GC,e P///Jet
el tg Address(number mod street city,sate,and ZIP code) --- — .❑ Same ds pmperty ochres, - — —-- -
//nt c2_' s. r toe4p1A / iv ici6ce ci
Spouse First Middle Last
Mailing Address(Number and street,city,state.and ZIP code) ❑ Same as property address
Social Security Number Ilan 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
5=
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.
Owner I Signature Date
CLAIM FOR HOMESTEAD PROPERTY TAX mf�
CREDIT/STANDARD DEDUCTION
` State Form 54473 (R8 / 7 -07)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions. JUL 1 7 2008
L� v
I (We) 9� M certify tharvWrA@"V6lfTKYaFiii, oR
(We) occupied as our principal 14ace o hVMMMIFIVellowing described real property for which a Homestead Property Tax Credit is hereby claimed:
® I (we) owned (D 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 •••
If buying on contras, Fee Simple owners name
Recorders office where contract is recorded Record number Page
STANDARD • r
20 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
PROPERTY
or 43,000 for 2009 pay 2010 40,000 payable after 2012
County
TomsNp
Taxing di rji (cif q town, township),
Parcel number
Legal description 41 ,TV ,4`c
is the property in question:
IV l c ?
(/ .Sw tiE ,,/ v —� /
1 ❑ Real property ❑ Mobile Fbma (IC 6 -1.l -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used b produce income, describe the use and portion
of the property utilized to produce income.
�, (_,o,-13 -3Y- A60- 00% J y6 -ood-
STANDARD • r
20 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
$
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of AJdtor
Data signed (month, day, year)
Land not exceeding 1 (one) acre immediately
surrounding residential im P improvements.
()
^` - ?• -�'°'� -. � � -
-
Other land
(2)
- ;
Total land (line 1 plus Pure 2)
(3)
Dwelling
(4)
..- ;..
',
Residential improvements or Annually
•e t
Assessed Mobile I Manufactured Home
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 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)
STANDARD • r
20 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
$
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of AJdtor
Data signed (month, day, year)