Homestead_Nelson STATE FORM 535e0(R3 I61a) TREASURER FORM TSIA
APPROVED BY STATE BOARD OF KCOINTS.}IXN PREYA1rID BY TILEDFPARTMET OF LOCAL GO\TAS'MENT FINANCE K 6-1.1-114.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
. Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher Lax hills for all;therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
' D r T L E benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
FILED 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.
PART l: PROPERTY INFORMATION
APR 2 5 2011 Taxpayer Name Location Address
C. .f+`�� , Nelson, James A
� �V\ 70796E50S
GIBSON COUNTY AUDITOR
OAKLAND CITY IN 47660
4321
- - -AIM IMilliiiill iiii liiiifii iiii i i iiiiiiii°iilHiLliii liilllllilii-llillliiliii iilii_ iil
James A Nelson •
10796E 50 S
OAKLAND CITY IN 47660-8628
State Parcel Number Legal Description 1 1I 1I 11 Ill llll 11 II I IPddP 11 d ub 1 nl 11111t 1 mh -
x
26-13-12-300-001.204-006/ S Sw 12 2 9 2.46
. 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.
0
Fill -----------' -----'---------PAR 2: ASP�>,l'ER IN O'r A 1:
t - - first _ -- -- diddle _ Last -.
dams` 1')C JO
I 1�1elSovA
Mailing Address(number and street city,state,and ZIP code) • 9 Same as property address
/0796 6 S S OAK)dnd ()It -t-1:- an 4/7660
Spouse First Middle Last
IVO n e .
Mailing Address(Number 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) - - Other(please specify in Part 4 below)
I I I I I I I- 1 I s�
- - -- --P AIkT3:CE:RIIFICATiON- - _ ..--..,. :.. -.__..._ ....,.... --
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 1 Signature Date
F + + <scii, 19,
nrv1:•erty for wh
SEE BACK FOR 'FILING INSTRUCTIONS r 1
Vw, O n i'1 1 _JJC�,�y. 7' D I of q-h i - certify that on the 1st y c
('vle) occupied as our principal lace of residence the .follo ring described real
i a l?cirastead Property Tax Credit is hereby being claiuiai:
1 ®� ❑ a.va
poi -Oi.oy j
e buyincT u.*rler contract
have a b�lneficial interest in the .taxpayer-�� �� ; o3�J� -�� a(Jy
Procc ty D_scria ion. in County 1a,a�:lii 4
T1 ---i ng District (City, Torn, 7t;anslLip)
parcel 11 umber or legal description slnom on tax statamst• �
i) 1 la-
?= b „y aIgo r e-rs nano (fee s' e c,-ner
Contract recorded in P_corc?er's Office - P�cord ib./h�_ Page
X907
I a r• oort o§ bi `Y'esi( ential structure or the land, not e=eeding one (1) acre that
ij-m- ._'C11a -'el �s that structure is used to produce .i.ncari°, describe the use and portion or
til °_ crop Z lice 1ILon
AUDITOR d
pm, other counties in Whic-h individ'a u.,,ns or is buying real pro party:
C".._T'i1 t�heI cpve stat9rlenl. 15 true, correct aiL� C07171e te.
t
county . ?tr:.aishio
, state and Zip Ccu.,
*Inciividisl eit}Mr a.,rns or is. keying uner a contract that provides he is to pay the
orep1 y taxes on the residence,. or has a h)eneficial interest in the taxpayer.
FOR ASSESSOR'S USE ONLY
un /ado RYA”
isy l not e<c°eding 1 (one) acre immediately
surrounding residential i.l'Prov--lients
O then Land
Tota1 Land .
Pesidential Inprove;rents
I�.elLing
Garaae
Total
Otile_r lI =,7EiilSn S
'!— Irorov�z,E;jts - Line (G) plus (7).eauals (a)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
True Cash
Value
"rekN C°rt' —Sjr i.Il °_ akX�4e 1S tI.�'_ °_r COLTeCtr and CCrimlete.
1�iLttir °_ of t'sses SCr
- ACT10I! BY UUDITnR -
Date
IUSessed tr-ii2stea::
Valuation' Valuatic:[
Da to
t�
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