Homestead_GerkinCLAIM FOR HOMESTEAD PROPERTY TAX FOR
1• CREDIT /STANDARD DEDUCTION HCt�
State Fonn 5473 (R2/5-92) �•
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INSTRUCTIONS: See reverse side for filing instructions. JUN 0 6 1996
CERTIFICATION STATEMENT
I (We) _ .w certify that on the 1st da RI?5119k�
I (We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
�1 (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
If buying on contract, Fee Simple owner's name .
Recorder's office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTI N
County
I Town
h
I hereby certify the above statements are true, correct and complete.
Taxing di
tri t (city. own (owns ip)
Parcel number
(b 3- `f3a
cri
Legal de Lion
+
+1 .s
If 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.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township _�
County
I
Townshi
I hereby certify the above statements are true, correct and complete.
Signature o latmant
'essss (number and street. city. state. ZIP code)
�V
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
-Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(2)
Valuation or $2,000
'
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 plrs line 7)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
r1
STANDARD DEDUCTION ALLOWANCE
19 Pay 19 _
Lesser of 1/2 Homestead
5
Valuation or $2,000
Signature of Auditor
o
N umlrlt-
Date signed
_
r1
STATE FORM S)SMIR,s-cs) . ItEASLRER FORM TSIA
APPROVED BY STATE BOARD OF ACCOUYFS,EN PRESCRIBED BY THE DEPARTMENT OF ISK.V.GOVERNMENT FINANCE tC 61.1-`.24.1
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 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 ro ide additional identif in information necessa to allow count
TT p ) g, ry y gwemmrnt to better monitor homestead
T �'1 filings.This information will be kept confidential and can only be accessed by authorized county officials.The Depamnent of
1 /L� l acal Gove tenant Fi ance will se his infonna ion o c eau cols that will help county officials eliminate homes ead fraud.
PART I: PROPERTY INFORMATION .
JUN 2 0 2011- - Taxpayer Name Location Address
Gerkin, Ron/Cheri •
I
C.J. (tom .. 4O1 S RACE
GIBSON COUNTY AUDITOR - HAUBSTADT IN 47639
2995 '
•Ron/Cheri Gerkin 111111n... IIIimmm-01111111]HIIII01111HII lIIAII_ii__IIIII�IIII-I0II0IIDIllII I111III
405 S Race •
Haubstadt IN 47639-8144 . •
III"III'IIIIIIIIIIIIIIIIIIIII'II'I'IIIIIIIII'IIIIII'lllll'IIIIII State Parcel Number Legal Description
26-23-06-101-000.432-009 /?T w 6-4-10 .5428 AC
•
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 -
0v. I First Middle Last
got-kaki Ewyene GerKt
n n
.
Mailing Address(number and street.city,state,and ZIP code) - ID Same as property tiddress
Lk°S S. Race S+. Haubsaad+, 711/41 47639 .
-
,
Spouse First - " Middle Last
Cher' ge h Ger'ktn
•
—Mailing AaNes(IS tuber and swat,city—'state and ZIP code)- -- - -— — '--D Same as property address „ - -
405 S. Race Si'. kaubsFad-41 I N 41639
-
-
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 Sigature / Date
•