Homestead_Jackson (3) On
STYE FORM 5rew 1R-r..Pt TPLASULER fORM YIA
.AflflED BY 515TE BMROO*MTn.NTS.:OM MUISCnam BY 11W DEPARTMENT OFLQAL GOVERNMENT FINANCE IC 4-1.1-r4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this dedtction bacon,..
more beneficial.there is more incentive than eser for homestead fraud.Ilomestead fraud causes higher in bills for all:therefore.
® F I l iE L HEA 1344-2109 requires tanpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to pan-ide additional identifying information necessary to allow county government to better monitor homestead
filings. This information will be kept conlidentinl and ran only be accessed by authorized county officials.The Ikpanment of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
OCT 31 2011 PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
C. .n Jackson, Stanley /61 963E /25- S
Atlitertr6-3—
GIBSON COUNTY AUDITOR
Oakland City IN 47660
1677 •
Stanley Jackson /;Jr S
R1 RnvRZ_. /09631
Oakland City IN 47660-8643 State Parcel Number Legal Description
L l l l I I I I r I l l I r r l l l l l l 111 11 111111 1 111 l l i l l l I I I I I l l l l l l l l I I I I I l 26-13-13-300-000/73-006 0003-00773-00 PT SW 13-2-9 2.781 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
",N le , / 1fcie, eJ ( T ckg0n.
ig Address(number and street,eity,state,and ZIP code) a Same as property address
®Q( 3 C>P' 5 e2/1,&Art,o( c. 'Ay , =-/v Y 2 .z).
?
Spo - Firtt Middle Last
Eggra Lyn/it( ar5o ry
Mailing Address(Number and street,city,stale,and ZIP code) '] Same as property address
16913E 125 -5 (�aia-Alur) ITy � .�..
41640
'
- -� -- --- ----- --
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.
'Ownal ' at Date
1 1 • • / I _� .
,o
7 � _ a'
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5-92)
INS/TR� UCTIONS: See reverse side for filing instructions.
I l t ---1
FORM
HC10
YEAR
C TIFICATION STATEMENT
I (We) certity that on the s
(We) Ie as our principal pla a of residenc he following described real property for which a Homestead Property T ediS inhere ^ claimed:
J I (We) owned ❑ Are buying under contract 19JJ9
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the prop or is buyin .un contract.
CONTRACT RECORDED Uf TY TOR
If b*ng on contract, Fee Simple owners name
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing distri Gry, town,
nship)
mbep'Y WW 7/73 O a
Legal description
e residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of
If arty portion of i
the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County Township
County
Township
Sign f claimant —M
ereby certify the above statements are true, correct and complete.
ss (rrum d street, Firy.te, ZIP I� D
1 IrC_J ITY �7 Lo (00
ASSESSOR USE ONLY
TRUETAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON-RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements -
(1)
Other land
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
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
complete.
Signature of Assesor
Date signed
verifying action - Signature of Auditor Date signed
® STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead $
Valuation or 52,000
Signature of Auditor I
Date s n C