Homestead_Strickland STATE FORM 5l5RF(R3 1 610) TREASURER FORMTSLA
• AMRWIFD BY STATE BOARD OF ACCOUNTS,YW PRESCRIBED BY THE OEPARTMEAT OF LOCALCO'ERNMEW FINAVR£IC 61.1424.1
• Gibson County Auditor IMPORTANT NOTICE 7'O 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 tax bills for all;therefore,
HEA1341-2009 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
T T filings.This information will be kept confidential and to create be accessed by authorized county officials.The Department fro of
feu, 1 Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud
I PART 1: PROPERTY INFOILIIATION •
OCT s 2011 . Taxpayer Name Location Address`
_ Strickland, Brian K/Jenny L .
C: .n .
12390E 150 S
Giervy COUNTY AUDITOR • oAKUND��cIIiTY IN 47660
Brian K/Jenny l Strickland I II I�I I I III�I I I VIII�I� II 01111 II 111�IID II_II_II I OH II I I I�I Bill II�II.I I�II
12390E150S
Oakland City IN 47660-7849 •
III'IIIIIIIIII'I'III 'IIIIIIII'II'llll'llIl"'ill' 'I1III111II11I State Parcel Number Legal Description
26-14-17-300-000.061-006 PT SW SW 17-2-83.61 AC C-1
r.
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.
t - PART 2: TAXPAYER 1NFOR IATION -
1 IL
Ov. ^ r l U ^ First e,l / .. Middle &J f/cli G, / Last
Mailing Address(number and street,city.state,and ZIP code) ( , 2 Same as property address
J390 I� 'l 5o S Dctk)G ^� (.4�7 (N. •
Spouse First 1 Middle t l) I // Last
Milling Address(NwnbL and street,city,state,and Zit coder " .[Tr uc as property address . -..
' • , - . .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 Signal \ Date
- •
a Rx� CLAIM FOR HOMESTEAD PROPERTY TAX
i» CREDIT /STANDARD DEDUCTION
State Form 5473 (R215 -92)
'vJ
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
CE ATION STATEMENT.`.
I (We) rtfly that on the 1st day of March, 19
II (We) as our principal place of re i ence the II 'ng described real property for which a Homestead Property Tax Credit is hereby claimed:
I (We) owned ❑ Are buying under contract
r _ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is#nyiblg4p4W-a contract.
CONTRACT-RECORDED-.,
If buying on contract, Fee Simple owner's name JUL 9 O 1999 -
Recorder's office where contract is recorded
- -
- PROPERTY DESCRI - B - . - :,e ". `- -
Counry
Township
NON - RESIDENTIAL
VALUE
Taxing strict ty, t n township)
33 4kjj
r� r
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.
�C -1�1— /7- -,344 — 4�• ��
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES.
County Township County Township
I hereby ify the a ve ements are true, correct and complete. Signature of claimant
�ress (number and street, city, state, ZIP code)
P0 kox 2S M'ac 4-?Wq
ASSESSOR USE ONLY
TRUETAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surroundingresidentialimprovements.
(1)
Valuation or $2,000
_ -
-
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)
(S)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
- STANDARD DEDUCTION ALLOWANCE' -
19 _Pay 19_
Lesser of 112 Homestead
5
Valuation or $2,000
Signature of Auditor / )
Date7!d 3O