Homestead_Buck (10) STATE FORM 53%O(R3 1 a-ID) TRFASLRFR FORM TS-IA
, APPROVED BY STATE BMRD OF ACCOUNTS.2C09 PRESCRIBED BY THE DEPARVME■T OF LO CAL GOr'RNMENTFLYAN'CE IC 61.1.224.1
. 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
FILE benefit and w ormidi additional identifying information necessary to allow county ized co nt tD better monitor homent o
filings.This information will be kept confidenrial and can onW be accessed by authorized rounry otHcials.The Depamnrnt of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud
PART 1: PROPERTY INFORMATION
JUN 29 2011 Taxpayer Name Location Address
_ C. . Buck, Jason
8774E 550 S
GIBSON COUNTY AUDITOR OAKLAND CITY IN 47660
8666
IIIf1_BIDIiiIltnfi 111111 II_IfllBll1BIlli 111IJasonBuck
8774E 550 S '
OAKLAND CITY IN 47660-8581
I'lil'II'li'I'IIIlli'III11111 III "11111"II'lll'IIII'I'lllIl'll State Parcel Number Legal Description
26-20-03-300-001.904-0017 SE SW 3-3-9 1.297 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.
_r �'s
Ow.. . l - First Middle Last
J5on Edward ' Buck
Mailing Address(number and street,city.state,and ZIP code) ['Same as property address
87'14 E 5E08 Oakland City ,IKI 410000
Spouse First Middle Last
_ _—Sr_ao-ke._ _ sussnne Suck
Mailing Address(Number and street,city,state,and ZIP code) Ef Same as-property address
671'1-E 550 S Oakland d* . 1 '-l(DLO
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 YEAR
CREDIT /STANDARD DEDUCTION Hcto
Slate Form 5473 (RS 14-03)
Presulbad by the Department of Locel Government Fina oe
INSTRUCTIONS: See reserve sida for Mhg irnburb'py. T-1 g
I (We) l XAAaou r 1 L certify th�" 112 lgt daunt March, 20
1 (We) occupied a our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
El I (We) owned ❑ Are buying under contract
a�,
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property oylsbuyigg -i under a contract.
-- `rC0NTRA CM. RECORDED
- ss+�Y�C`�^ti4�..d`�ei3i �2 ^`3�•C' =LN%>� ��FV iL�
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
`.— W�.'cin� Y�� sFtz+'Y✓i*•a- 'S1;!,. >> P. ROP ,ERT,Y:�DESCRIP,TION?.�"_ -`s" z_.
'.5.__ .., 4� --
County
To+ nship
Tadng district (city, town, township)
P Inu— b1 q Oq.�
t
Ide 'Pa 3-3 -9
Ad in end street, dry, ate, ZIP code)
gclao 1 4 ?66
Is the property in question:
[I Real property ❑ Mobile Homo (LC. 6-1. 1-7)
H any portion of the residential structure or the land not exceeding one (1) acre that immediately grounds that structure Is used to produce income, describe the use and portion
of the property util¢ed to produce income.
0 -a3- o- , too
Ri�' a5 .'�"�'..��l+�ir_''2= �- .�"��'= PROPERTY OWIJEDT9YCl= A1MANT,IN; OTHER" COUNTIESt ,�.r.+f_1�:�.`- �i'2- ��rig�,iss -�,
County
Township
County Township
hereby certify the above statements are We, correct and complete.
i atu o claimant
AAM
Ad in end street, dry, ate, ZIP code)
gclao 1 4 ?66
F s it r:' S� T' - T...'Fn, �.+i4
�tYASSESSORUSE ONLYytr;
'
a.•t- rxt.q.,
*TRUE TAX+T=vf
ASSESSED VALUE
-.
HOMESTEAD-
NON±tESIDENTIAL
vsrks • p�FvJyy =_y?,i�vl,l��A?"ta- ''a;=C•` r-
�e.�VALUE
.AT4100 10F�TIV,A
VALUES„`x,y
*wVALUEy'`r�` r'
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land _
(2)
t.�gsr -x
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
441:Frf q 4'ay
M
Residential Improvements or Annually"
^f�'• ^'_ y�F
Atlseased AAobBa / Manutaci mm ured Ha
Garage
5
( )
-Ir T
a
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7) .
(S)
1 hereby certify the above is We, corned, and
Signature of Assessor
Date signed
complete.
Venlying action - Signature of Auditor
Date signed
?- %a,�S--`k�a-gW-&-?44'fsb� -�-�. STANDARD DEDUCTION - ALLOWANCE. '_ ;j• ' 3 "E -' ,;',1#'i ±i �t -,:P.
20_Pay20_
Lesser of 1r2 Homestead
valuation or S35.D00
$
Signature of Auditor
Date signed
U �