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Homestead_Jenkins (2)i STATE FORM 53560(IU/&n,) TREASURER YORM TS-IA APPROVED BY STATE BOARD OF ACCOUNFS.NM PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT• FMAVCE IC 61.1.214.1 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 1 344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the ® IF I I_, TI D benefit and to prmide additional identifying information necessary to allow county government to better monitor homestead• �1 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 I: PROPERTY INFORMATION — MAY 9 2011 Taxpayer Name Location Address C n Jenkins, Louise 4359 S TALEIA DRIVE GIBSON COUNTY AUDITOR OAKLAND CITY IN 47660 759. 11111111111111/11111 1111111111000111101111111__11_111DI11111 ][ o111:111 LouiseJenkins 4359 S Taleia Dr OAKLAND CITY IN 47660-7651 IIIIIIIIIIIIIIIIIIIIINIIIIIIIIIIIlIi11I11III1II11 11111111111111 State Parcel Number Legal Description 26-13-34-400-000.998-006/ PT SE SE 34-2-91/06 AC 5 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. _` il - Os,. . I First Middle Last 1r U1S1C- - MI like�d� Mailing Address(number and street city,state,and ZIP code) L.Lr Same as property address C-1_3 5-9 S T&c w(A bl 2 Spouse a First Middle Last Mailing Address(Number and street city,state,and ZIP code) El 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) • l I I I I I I I • I stns 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 unlawful) ,he or she may be lia P le for back taxes and substantial ial penalties. Owner I S' t I Date s c CLAIM FOR HOMESTEAD PROPERTY TAX 1 YEAR e �1 STANDARD w 13 SUPPLEMENTAL DEDUCTION 0/1 10 — '� Prescribed by the Department of Local Government Finance / I • INSTRUCTIONS:See reverse side for filing instructions. I tg:4.ii,. r t_. >.-F3' eitI.M'sV:ti tti:Z3.1.,k'ri!'{+c`.CERTIF:ICATION;STATEMENT a'Si . _ ;-w1ni,#`ar Atirri`''1.saVii^.q`mom.. ri•.... :,7.r:. 1 M I(We) �� l/ • I _ ." certify that I(wej o tcu if eicfitf o"ur)principal place of residence or am(am)buyi le following described real property for which a Homestead Property Tax Standard Deducts h-Is rtejeby claimed under contract on the date this sppli•:tion is filed, (date of filing). I(We): GIBSON COUNTY AUDITOR Own ❑ Am(are)buying under recorded contract Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust ❑ Am(are)the shareholder, partner or member of the entity that owns the property. V- r.R . J r c Y3 S s." .. .. 5..,, Y' F 1.a^• chi'+.:. s y - �'i�4 �-. >.x j-_<''�,;>_itrx:?St. �>^i„.vr.�irct3i.!V-�°ts„��_'�:J{�CAIMANT-S INFORMATION,';`__3,;:,sy,;..,..acks�lG,.. +�.t... r� �'!.'.!'�lF?4.i�^�' ._•�„�.'. sFi Name of..0,.1 legal name) Al • Social Security number of dahnant's spouse(last five digits) Drivers license I Identification/Other number Issuing State of claimant's spouse(fast five digits) i - f -f-WiZhr'ti i h -. ,..sYS-.. .t t:.t c -xa1 t u5 J tan.-.r i f 4-it.:t. t.�.a•`i•->�. _�_ ..t.,v , , 5��.,:r• -r~-w .x�'�JiL��CONTRACTrRECORDEDi_t�'_��T'.,tZ as.?1,....=.s.Ti7 �t�.v+..�,,..:..v S' v ..-.,;...•...r. If buying on contract,Fee Simple owner's name Recorders office where contract is recorded Record number Page . . y r:. :3 _ ... o- TZ-ZE . _..___ . ._..._ •'--#S Y ••`u NY C'.,; r .: ;i% h. :,'a-.�-•'`'>µ_�.a. �x.v t:+...+.� h°-`.2.. `i+?2':'y.�t1Ge:+.*,a'�PROPERTY.DESCRIPTION-,use'.t`t.�,.z #.„ '_A��vNr,'._,..u_,_�.;C'Yt�.. ...� F'b .^_'t_ ... .. County // / Township Taring �� (pltY,town,to abip� Parcel number C/l-/✓” Legal description Is the in question: Real property ❑ Annually assessed mobile home(IC Gf.1-7) If any portio a residential structure or the land not exceeding one(1)acre that immediately su at structure is used to produce income,describe the use and portion of the firmed to produce Income. off/ -/3—.3� — (WO. 969—W‘ 5i•'(ygt4_tEgZI*?rr'4,.t,w:;¢'tt,rM:;this'"je"PROFERTYrOWNED1BY,CLAIMANT IN OTHER-.000NTIES�- 6''.t;yrQ``'_{6::: »<_{;W:-5,r e_icliz. i County Township County Township • I hereby certify the above statements are true,correct and complete. Signet/ure of daima Address(q ∎ street,city,atata" L Cs 14 ID K O K L .0 P C I 1—Al ' lib 60 CJ 't 3 x,.+6 t + - a s4,'h!. -- �vt �Y F r n a gSSESSED VALUE'.1s HOMSTEAD.°c - �Y`NON-RESIDENTIAL'•,:.':". 4 iiy?, %'�..lu•�ASSESSOR USE ONLYC��, to 'u�• f TRUE TN(VALUEs.I_AT.'_100 ro OF TTV I.j. .,VALUE+ n..Ia,3�3..-oraz.•;_-L"•.VAL'UE.ck,i-: i,:: Land not exceeding 1(one)acre Immediately t i. )Ss'y� g1 h surrounding residential Improvements. (1) � , Other land (2) -ate'.0.1 -3 :- Total land(line I plus line 2) (3) Residential Improvements or Annually Dwelling (4) i`.r.efaSP r.;Mi ei,n£q.?f Assessed Mobile I Manufactured Home Garage s $ `'I` ' r r x Other Improvements (6) :X :t u'.., Total improvements(line 4 through line 6) (7) Total value (line 3 plus line 7) (8) I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year) and complete. Verifying action-Signature of Auditor Date signed(month,day,year) ELI":kWgZ.4 'IL'ltiR h 3 4111:"isY 7AWSTANDARD.DEDUCTION ALLOWANCE ii €IFS A y SM_"l, xt?,M*PZi`!.'i, 20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000 i Notwith standing any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home that is $ \not assessed as real property or toe manufactured home that is not assessed as real property may not exceed \ one-half(12)of the assessed value of the mobile home or manufactured home. Signature of Auditor Date signed(month,day,year)