Homestead_Mosley SIAU FORM 535'IR'/f WI TRFAStiUR FORM TS-IA
APPROVED By bait BOARD OF 4-01..1a.:in. ?tn,Jnn BY tilt DEPARTHEC(W LOCAL GOVEIW.LT'i MANGE M VI.Ir-t1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individua6 and married couples are limited to one homestead staandaoJ deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.Itome-stead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayer,who receive the homestead standard deduction to verity that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings. Ms information will be kept confidential and cnn only he accessed by authorized courtly officials.The U pane ant of
Local Government Finance will use this information to create tool,that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
— Taxpayer Name Property Address _
Mosley, Thomas E/Rosalie S 'G5 jQ 5 1 as
-"P — O✓ R2 Box 276
Oakland City IN 47660
5148
Thomas E/Rosalie S Mosley
PO Box 302 State Parcel Number Le_aI Description
Oakland City IN 47660-0302
26-14-18-204-000.893-006 003-00893-00 PT SE NE 18-2-8 AC
1t1u11u t�L��ru��u��ut�� Iltll ��� 1118811 C-1
X
5
PART 2:TAXPAYER 1NFORNIATION
Owner I First Middle Last
�Ho/Ms r=c/GtryN� Mos L e-y
40,g Address(number and street.city,state,and ZIP code) O Same as property address — — - -" -
P 0 9-\i 3c4 0 0 a, _lA/y 7110
Spouse First Middle Last
f2cs,AC /Ls SyL V/A HOSLLy
Mailing Address(Number and street,city,state,and ZIP code) ❑ Scene as property address
Poac�C 300 ao�.. JC4 /// W 7660
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
s� CREDIT /STANDARD DEDUCTION
State Form 5473 (R215 -92)
ray
INSTRUCTIONS: See reverse side for filing instructions.
- = D
1
I (We) y certify that on the 1 st day of March,1ijTnR
&-) occupi ' as our pn ..pal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
PI (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.
CONTRACT RECORDED .
It buying on contract. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION -
County
Township
Taxing dict (city, tow township)
Parcel number
0 C-') 3 �o8c
Legal description
It any portion of the 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 the property utilized to produce income.
X93— e�o-�
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
�eby certify the above statements are true, correct and complete.
Signatur Uaimant
000444aaa...000ZJ/yyyy-
Address (number and street, dry, state. ZIP code)
Date s ned
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON-RESIDENTIAL
VALUE ,
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Signature of Audit r
Date s ned
Other land
(2)
Total land (line I 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 pUs line 7)
(g)
I hereby certify the above is true, correct, and -
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
A
Date signed
STANDARD DEDUCTION ALLOWANCE
19 _Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
S
Signature of Audit r
Date s ned