Homestead_Anderson STATE FORM!r!N 1821 TREASURER FORM 13-IA
RArIMPORTANT NOTICE TO DEPARTMENTOC LOCAL COVERNWICT FINANCE IC
OPERTI OWNERS t„
Gibson County Auditor ,
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
mere beneficial.there is more incentive dun net for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
FILE HEA 1 344-2009 requires taapayem 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 he kept confidential and can only Fe accessed by authorized county officials.The Ikpanmem of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
APR 1 2 Zulu PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
aa 4% .c Anderson, Jerry UJonie M
O'f R I
GIBSON COUNTY AUDITOR
OWENSVILLE IN 4766
1769
Jerry L Anderson
9406 W 400 S State Parcel Number Legal Description
OWENSVILLE IN 47665-8943
26-10-34-100-004.718-021 D 116-2201&OOW NW 342123.232 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Jt°rr9 Lynn. Tlrdtrson
:g Address(number and street:City,state-,and ZIP code) — - - - — __ I r Same m propem addtus - -
40� n-
4-00 S . nwesui ll "I LI-7 A cc—
Spouse First Middle Last
J On 12. MLk rl ftrLd ers
Mailing Address(Number and street,city,slate.and ZIP code) lL Same as properly address
140(0 (,J• Laos D (Aron so IIV 474, 63"
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 (J FORM YEAR
CREDIT /STANDARD DEDUCTION THCio
State Form 5473 (R614-03) -{
Prescribed M'the Department of Local Government Finance -Ji' 1dJ
INSTRUCTIONS: See reverse side for filing instructions. 1p
I(we) lb44 V I ate- Wthe'15td
r Iay.of March, 20_
I (We) occupied as our pdncip lace of resi ollowing de abed real property far which a Homevtead Property�Ta>( Yre.lt by claimed:
❑ I (We) owned ❑ Are buying un er ntract
'` 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.
..%a�E�/''.#c-r- an�- ;;a''�c ONTRACT;'RECORD -',. - -�"-i'3 a'zk �:
ED a`�'�ci -'��" xi ''�3ti1�.�9�+- '�- �:�.."A- +a;,.$
If huyug an contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
�'=r•� 7:. s.' ??��.':z,:�,v'P,ROP,ERTYOWNEDBY CaIMANT;IN:OTHER`000NTIES �_ =rid .u•?,r�x�'�,.q„"�j�y; ," �., }'1 'Y.-?
: P, ROP, ERTYAESCRIP, TIONf. s�' r" a. rivf?"?, 3x.'` c�``., :.:d"%�;+�r�•^-- c„+.xb,,y,t, -`•
n
Tomship
Testing district (city, to
e
_,Address (number end street, city, state, ZIP code)
90
"AT 100Ye OF TTV
Par nu bar O w
7 /
Legal as ibft� I 1 %r /_�� the property in uestio.
( /C� /1 /Wl ✓i' property MoWIe HOmol 7J -7)
If any portion of the residential structure or the land not exceeding one (1) ace that immediately wmounds Nat sW cture is used to produce income, describe the use and portion
of the property utilized to produce income.
(1 i
�'=r•� 7:. s.' ??��.':z,:�,v'P,ROP,ERTYOWNEDBY CaIMANT;IN:OTHER`000NTIES �_ =rid .u•?,r�x�'�,.q„"�j�y; ," �., }'1 'Y.-?
County
Township
County Township
I hereby certify the above statements are true, correct and complete.
Si a e f claimant
_,Address (number end street, city, state, ZIP code)
90
"' -0� "� -? `�' s "rux -°-•sl
�2 ASSESSOR USE ONLY z s
7�ftr TRUE TAX+
+
ASSESSEDVALUE
HOMESTEADFi
��NON= RESIDENTIA'r
a`:- :c ..mss. s'.�C+..e :� a .,r a:`.5 •>rL .- F,�. }ks �:
VAI:UE�� -,"",.
"AT 100Ye OF TTV
, IUEr
+_ "a VALUE' OU
Land not exceeding 1 (one) acre immediately
improvements.
(1 i
surrounding residential
,'a3v'i'l+sb'+ f ••sal?
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)'ti^.
ti Y.7X'xaY 'rd'�3
.';
i�.,+�
Residential improvements or Annually
^`
Assessed Mobile I Manufactured Hoare
Garage
9
( 5)
r+ nn r
Other improvements
(6)
y' "' r�
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(g)
hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of wtlitor
Date signed
ss.a'', .,:. �. . «��'�tx�n••".''�+t`,3`e��'n�` STANDARD_! DEDUCTION'ALLOVIIANCE „v$����."'f.�'y�% yeses” �' zvr;s��- r'F?L�'xi`%,',:'�,L "d'�+��:
20 _ Pay 20 _
Lesser of 112 Homestead
Valuation or 535.000 $
of dhc Date sigry;p