Homestead_Riley STATE IO1tI!)!Mt a_r■+rvt TtIASlafII FORM 75-1A
VPMA'Ef BY SI ATE BOARD OFAC(AINTNbm PEFTNBEW By fir DEPARTKEVTF EAaL eXWERNMrrf FINANCE M 6-I.I-2:41
Gibson County Auditor Main
101 ,ti 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 deduction becomes
more beneficial.there is more incentive than e'er for homestead fraud_Homestead fraud causes higher tax bills for all;therefore.
40 HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recebe the
benefit and to pto''ide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be Lent confidential and am only he accessed by authorized county officials.The Depanment of
Local Government Finance will use this information to create tools that will h;lp county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Riley, James R/Lori M
RI I3ox85A
Oakland City IN 47660
1679
James R Riley
40969E 100 State Parcel Number Legal Description
KLAND CITY t 47660-8653
26-13-13-300-001.318-006 003-01318-00 PT NE SW 13 2 9 7.402 AC
r ut n nrstn ntrnr n urn nr 'y/ C-1
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
�arne5 PaLY Address(number and street,city,state,and ZIP code) l r l Same as perty address
(09UP L lCD 5- ` Oaklonc1 1k k?7(40(DQ
Spouse First Middle Last
[or ' h'l(Melle , )I��amIIc�
Mailing.Address(Number and street,city,state,and ZIP code) LN a as pm y address
I f (99 1=.. (a) 5. ))(J band Q/&q `` /A/ q 7&&)
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is elieible 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.
Ow' Signature /S Date
-
•
CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
� CREDIT /STANDARD DEDUCTION CRo
` State Forth 5473 (R817 -07)
Prescribed by the Department of Loral Government Finance
INSTRUCTIONS: See reverse side for figng instructions.
r• r
I (We) �--�� certify that on the 1st day of March, 20_
I (We) occupied our principal place of residence the following described real p r which a Homestead Property Tax Credit is hereby claimed:
'e) own ❑ 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.
If Wyutg on contract, Fee Simple owner's nama
Recorder's office where contract is recorded Record number Page
PROPERTY, OWNED BY
County Tavnship
County Township
I hereby certify the above statements are true, correct and complete.
Signature of ciaimam
PROPERTY
County
TomsNp
AS§E�SED VALUE
T m qj district city, tom, town trip)
Parcel number
Legal description
AT 100% OF TTV .1
Is the property in question:
Lard not exceeding 1 (one) acre immediately
I R I property ❑ Mobile Home (1C 6- 1.1 -7)
It any portion of the residential structure or the land not exceeding
of the property utilized to produce income.
one (1) acre thal ounds that afn xn, re is used to produce income, describe the use and portion
-
PROPERTY, OWNED BY
County Tavnship
County Township
I hereby certify the above statements are true, correct and complete.
Signature of ciaimam
Address (number and street, city: state. and ZIP code) ' _
V �`+
ASSESSOR •
AS§E�SED VALUE
• .. NON-RESIDENTIAL
AT 100% OF TTV .1
VALUE VALUE
Lard not exceeding 1 (one) acre immediately
,-
surrounding residential improvements.
-
Other land
y
:r
''� .4 �; 'x•fi�;; _._,.
Total land (fine 1 plus fine 2)
(3)
DDwelling
(4)
Residential improvements or Annually
Assessed Modle 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 We, correct, and
Signature of Assessor
Date signed (month, day. year)
complete.
Verifying aaion - Signature of Auditor
Date signed (month, day. year)
Wpay 20
of 112
Homestead Valuation
or
Signature of Auditor
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012 $
43,000 for 2009 pay 2010 40,000 payable after 2012
Date signed (month, day, year)