Homestead_Jarboe (2) STATE FORM 53569(R'•5.09) TREASURER FORM TS-IAI
• APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.131-5.1
.. ' '-IIVIP-ORmT�ANT NOTIOE TO IIOMt STEND PROPERIT ' OWNERS-
. •
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
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 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.
PARTE: PROPERTY IN ORMAr I 0 N . •
Taxpayer Name Property Address State Parcel Number Legal Description:
Kelly C Jarboe - 0 CR 1275 E 26-14-17-300-000.466-006 E SW SW 17-2-8 8.98 AC
OAKLAND CITY IN 47660 C-I
1 'I 4-
Complete and return to: Iu�]II[IH�IIIIE!] .itIMID1110111M113Ii]m0]0110Ii]t➢VU
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
Owner 1 First > Middle -- Last
77 ,, v Cily�zLES JA23oF
Magmg Address(number and street,city,state and ZIP code)
Same as property address
/ 3 3 9 S / .2 7,�c_ sec.,>rr� C', r'/tti-',v �/7v
First Middle Last
•
Mang Address(nxanber and street,city,state and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License State ID Number(last 5 digits) state Other(please specify in Part 4 below)
-... ION. -
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 sub tantial financial penalties.
Owmr 1 Signature Date
°
ic,.
FILED
.1, OCT 3 2011
L.J.n L.-t..y
•
GIBSON COUNTY AUDITOR
CLAIM FOR HOMESTEAD PROPERTY TAX FORM RM
CREDIT /STANDARD DEDUCTION HC10
State Forrn 5473 (R? 15-06)
Prescribed by the Department of Local Cwcmrment Financa
INSTRUCTIONS: See reverse side for filing instructions- rLWy ED
I (We) certify that on the 1st day of March, 20
1 (We) occupied as our principal p of residence6Ke following described real property for which a Homestead Prope"- r1e#
reby claimed:
i (we) owned ❑ Are tving under contact GIBSON COUNTY A DITOR
AHave 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
CONTRACTeRECORDEDfPA-N'§�,;o),hp44,� WW"ong
If buying on contract Fee Si rple owners name
Recorder's ofke where contract is recorded Record number Page
n, ILIA
County
Coin
Tcarnship
Taxing district (city, to
Pa nxMer
Legal description
)-006
Is the proprty . m question,
1 N:bRW property ❑ Mobile He. (LC. 61.1 -7)
H any portion of the m I acru, that immediately surrounds that itructure is used to prod" income. describe the use and portion
of the property utilmd to produce income.
NOY*Eb'BYCLAIMAN'Tik,6THEFi'COUNbFSIK
County
Twnship
I
County
Township
1 19
I hereby certify the above staternerits are true, correct and cornplete.
tpramre of 7-1�4 010 0
/I
MW
kUk ONLM
.TRUEtTAX,4
A
HOMESTEAD
NON41ESIDENTIAL A&
Lesser of W Homestead
Valuation or SM.ODO $
el c�
OWN, VE�
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'ry
1oAjV1tW
—16a`
SM -10 -0
Land not exceeding I (one) acre imiriedately
i'll-PH 0"
surrounding residential improvements.
1
Other land
(2)
Total Land (line I plus [no 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Garage
(5)
Assessed Mobile Manufactured Horne
Other improvements
n a
RON
(6)
a.
Total improvements (!me 4 lifiratigh line 6)
(T)
Total value (fine 3 pits line 7)
(8)
1 hereby certify the above is true, correct, and
SignatureolAssasser
Date signed
complete.
Veffywg action - Signatiffe of Auditor
Date signed
0-- -4 L�� V STAN DARD'DEDUCTIONVALLOWANr-E�*-'�.�"Ae
g". 'p� i, �K, 4>t
"gzo
,
-
20_Pay2O_
Lesser of W Homestead
Valuation or SM.ODO $
el c�
"
'ry
1oAjV1tW
—16a`
SM -10 -0