Homestead_Pennington (2) SMA1E Oa:W g IR t f+rtl - TREASUIER FORM TS-IA
APPMm'ED BY SATE MAUI of AfTllTi_ou r4C%NnmD BY 111F D[PAIMITNTOr LOCAL GOVELNMEin FINANCE ICsL1U-iI
Gibson County Auditor
101 N Main 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 es er for homestead fraud.Homestead fraud causes higher tag bills for all:therefore.
• HEA 1344-2009 requires aspapers who receive the homestead standard deduction to verify that they am eligible to creche the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings This inlnrmaiion will he kept conlidemial and ran only be accessed by authnri,ed county officials.The Depannient of
Local Government Finance will use this information to create mods that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Pennington, Wayne A
R2 Box 325
Haubstadt IN 47639
7380
Wayne A Pennington
509 W SR 68 State Parcel Number Leal Description
HAUBSTADT IN 47639
26-18-36-404-000.004-009 013-00004-00 PT SE 36-3-11 .96 AC
PART 2:TAXPAYER INFORMATION
Owner I First Alan n Last
�4yn2 _ ,Qlan Plenn;115-ton
tg Address(mmnber and street,city,sate,and ZIP code) - - - — Slime as propcdv address
-- - - — • --So IA) ST4 ( g i'ktbs+4d-f,T,1 4-6
Spouse First Middle Last
Mailixw Address(Number and street.city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's Liccnse/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sa:
PART 3:CERTIFICATION
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 FORM
CREDIT /STANDARD DEDUCTION HcTo
State Form 5473 (R7I5M
Presvbed by the DepaNnent of Local Go ownr end Fnaca
INSTRUCTIONS: See reverse side for Ming instructions. _
.: ` -.,., �; ...,.._ � -..rr ,i':. ; ^ ,' •.... .s�;.';,�.. .' '.CH2TffICATiON,STA7Flff11T;,
I (We) 0 certify that on the 1st day of March, 20_
1 (We) occupied as ourkhmcipal place of residence the following ddibed real property for which a Homestead Property Tar 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 ems the property or is buying under a contract-
>':4� •CONTRACT:RECORDm�:'zf ..m nXF ?•�v. -�`•1 x�.
If buying on mm6acL Fee Sunple owrees tame
P amrdWs of&e where cubed b reowded Recerd number Page
N s_.:'` =
°- "• PROPERTY DESCRIPTION"
A.
Candy
TUA —hip
I Hereby certify the above statements are hue. cared and carplete.
Tadrg district (cily; town, torw+.dnp)
'
nWbw
Legal deeciptian
VALUE �' y
Is the property in question:
;tin' W .FE
-
❑ Reel ptpaty
❑ M.W. Hans ( /.C. 61.1 -7)
a arty portion of the resKWasbucturewtheland not exceeding one (1) ace that immediately surtards dal structure mused b produce income, desc be the use and portion
of the properly tb'f®d b prod,ra vmmrtre.
Pt
,k 3 (o-3 -11 . ?1 44r-
...,,, PROPEiiI v UYYNED BY. CLAO111NT Oct OTHER COUWhES „- .. . s i. • �. ' r- - j'rr'` t"
-
County
Township
County
Tomship
I Hereby certify the above statements are hue. cared and carplete.
Sgnaturs of derma t
rY
ir(nun ber and sheet ofy shah. 71P Dods)
dILY
'. I. ,'. ° { - ...i STANDARD. DEDUCTION ALLOWANCE -:e: `,3 + r _it:• +.r,.. `�.:n'._.fi AS'- f. -`.y �+�`^"`.r
ASSESSED VALUE
J`HOW,STEAD -.
- LNON4ESbtTU10 Ttf`
Lesser of 12 Homestead
:I *ASSESSOR USE
rY
Valuation or f35,000
VALUE �' y
;tin' W .FE
Land net exceeding 1 (one) axe irraneclatelY
surrounding residential improvements.
,?,��3�
::l^'a.$Sr:.['�/r.. %r!y'tY� &,!}
Other land
(2)
Tdal land (Ime 1 plus fine 2)
(3)
Dwelling
Dwelling
(4)
Residential cnpnmrnents or Annually
Assessed Mobile I Manufactured Home
Garage
(5)°
Total 'mprovemerds (!ere 4 through fine 6)
(T)
TcW value (Ime 3 pha fine 7)
(s)
I hereby certify the above is hue. correct, and
Signab" of Assessor
Date signed
Vartyvng action - Signature of Audrsc
Date signed
o,
'. I. ,'. ° { - ...i STANDARD. DEDUCTION ALLOWANCE -:e: `,3 + r _it:• +.r,.. `�.:n'._.fi AS'- f. -`.y �+�`^"`.r
20 _Pay 20
Lesser of 12 Homestead
S
Valuation or f35,000
Signature of A Mer
Data signed