Homestead_Bostick 511TE IOR]I5SN4IC/vWl TnFASUm FORM iSIA
.APPROVED BY RATE BOARD OfMTrtAT[`nn PRFYA®(D BY ills DEPMfMFR OF LOCAL HOSTER:MG,FINANCE IC 6-I.l1:-tI
Gibson County Auditor
t: 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 ever for homestead fraud.h om estead fraud causes higher ax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive a the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be tryst confidential and can only be accessed by authorized county officials.The De anmenl of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Bostick, Jacqueline S/Pamela
S/Thomas E
218 Yellow Dog Lane
Elberfeld IN 47613
3309
Jacqueline S Bostick
8410E 900 S State Parcel Number Lefal Description
ELBERFELD IN 47613-8427
11111111111111111111111111111111111111111111111111111111111111 26-20-28-200-001.415-001 001-01415-00 PT NE NE 2839.687 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
Owner I First Middle Last
TflG u,kt/yt /L30S7-/G /r
•ng Address(number and street,city,state,and ZIP code) n Some as property address
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) I I Same as propeny address
Social Security Number(last 5 diigits)�Q' Driver's License/State ID Number (last 5 digits)L Other(please specify in Part 4 below)
Y-05/ <" R-Sf -6.3-2-1-r?�C
_ _ _ Sate
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 ' attue Date
S
fE f�E D F ALX TI Su ((�� ( sfer
CLAIM FOR HOMESTEAD PROPERTY TAX day of FORM M YEAR
CREDIT /STANDARD DEDUCTION JUN-T-70-0- HC�o
Slate Forth 5073 (RB / 7117) Q/( Audioo
,. Prescribed by the Department of Local Government Finance
son Count y
INSTRUCTIONS: See reverse side for filing instructions.
�o k
I (We) �1 G, Loci l�C 1, n 2 '3 s c- certify that on the 1 st day of March, 20 _
I (We) occupied as o r principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
kT I (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.
CO ORbED
If buying on contract, Fee Simple camels name
Recordees office where contract is recorded Record number Page
ASSESSOR USE ONLY
TRUE TAX VALUE I
ASSESSED VALUE
County
I I p�
PROPERTY
Twmslup. /�� /
/ ,..G- r TO K
Taxing district (city, town, township)
Parcel number
- .)O -.;) i -'00 -DO /.
Legal description
VALUE
Is the property in question:
1 ❑ Real property ❑ Mobile Home (IC 61.1 -7)
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.
ASSESSOR USE ONLY
TRUE TAX VALUE I
ASSESSED VALUE
HOMESTEAD
NON-RESIDENTIAL
AT 100% OF TTV
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile l Manufactured Home
Garage
Other improvements
(6)
Total improvements (fine 4 through Zino 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is We, corned, and
Signature of Assessor
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day, year)
STANDARD DEDUCTION ALLOWANCE
20 _ pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser 44,000 for 2008 pay 20D9 41,000 for 21 pay 20 12
Homestete ad d VAua tion $
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of motor
Date signed (month, day, yr)
- __?-r)9