Homestead_Grindslade •
SlATE FORM 53MNIR:I W.I MIASMA FCIAM t5-IA
APPROVED BY ST kit BOSRDrwvT Nrs 21,74 PIIISCAJBED BY THE DEPARn MSE LOCAL rov2RNNEM EP:AVCE MMY"-LI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tat hills for all:therefore.
HEA 1344-2009 requires tatpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only he accessed by authorized county officials.The Ikpanment 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
Grindslade, Robert D Jr
CR 550 N
Patoka IN 47666
64
Robert D Grinslade Jr Jr.
R1 Box 53 State Parcel Number Legal Description
PATOKA IN 47666-9050
111111111111111111111111111411111i m11 1111 IItE tE IIrrIIr1 26-04-11-4000)-00000.213-018 010-00213-00 PTE SE 11-1-11 19.61 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
9\0be.ct G c ; ns\o. se,e- 3
g Address(number and street,city,state,and ZIP code) E'Same as property address
Co 21 \A1 650 r4 . P x-17U(.42cn
Spouse First Middle Last
Mona L Gc in n&
Mailing Address(Number and street,city,state,and ZIP code) ra rite as property address
- -- ----- — -- _--
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 aturc p Date
PART 4:ADDITIONAL INFORMATION
111
CLAIM FOR HOMESTEAD PROPERTY TAX FORM - r ' YEAR
CREDIT /STANDARD DEDUCTION HC 10 '; 4
/ State Forth 5373 (R6 /4-03) 1 t 1 I
Prescribed by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side for filing instructions. F f p '1 LOO
certify that. on. the 'l st day of March, 20
,u.., - r�1 t -v.
I (We) occupied as our principal place of residence hie following described real property for which a Homestead Property�Tax Credit is hereby claimed:
❑ 1 (We) owned ❑ Are buying under contract
IN
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.
'.- ti"'. N># c' f2s "�3s•it_"1:e{:CONTRACT:RECORDEO ,'s' :Wjz.'r't
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
- mo
�..P,ROPERT.YDESCRIPMON
County /
7�
/J,2
Taring tlisttict "/'j 9, (ciN, t , toro .
Parcel number
OV — D O 2 _ 690
Legal description
�L', �VALUE�
Is the property in question:
inHeal Property ❑ Mobila Home Q.C. 6.1.1 -7)
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If any portion of the residential structure or the land not exceeding
of the property util¢ed to produce income.
one (1) acre that immediately surrounds that structure is used to produce income. describe the use and portion
'e —e)
- eez.o?/3 -aid
`�.9ia`'- ice". ��y.rhrzy�7`_�PROP,ERTYOWNED;BY CL' AIMANTIN';OTHER`CO(1NTIES'�'`.` Y`'d"'°•
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signal e o clalment
-Address number aM Street, city, state, ZIP code) / /
7ikT �f4'
LJ
W +' 'mss' r >' G
.. �s SASSESSOR'USE ONLYr "
'Y`TRUE TAXf'
ASSESSED VALUE
-!HOMESTEAD
NOW RESIDENTIAL h
��-'.
`nk`�' rs.. r
VA_L_UE'•, rs
}AT 11113%�OFTTV�
_
�L', �VALUE�
VALUE
-is� '"�� •.�:
Land not exceeding 1 (one) acre immediately
parr Sa- '.- 'pl+^•R
surrounding residential improvements.
Other land
-
(2)
s�
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residentialimprovementsor Annually��'��y'
Assessed Mobile / Manufactured Home
Garage
(5)
?'
P
Other improvements
( 6 )
3
Total improvements (line 4 through line 6)
(7)
,
Total value (line 3 plus line 7)
(6)
I hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20 _
iser of 111 Homestead
rauatlon or 535.000 I $
signed