Homestead_Menke II
STATE{ORM!!M.fie f..NI TREASURER FORM 11.1A
APPROVED BY<ISMt BnlPDOF MYSRIAT<.by PlU3AaB(D BY no DEPMIMEYF(F MAI.GOVERNMENT rfrascEMtrI.I-r4.1
-b-Gibson County Auditor
101 N Main u 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 eta for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 1344-2009 requires tatpapen who receive the homestead standard deduction to verify that they are eligible to remise 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 on only be accessed by authorized county officials.The Ikpannient 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
_ Georges, Marshall G/Lavada J ��
R3 Hox 1 I I Aa
Oakland City IN 47660
775
Lavada J Georges
6531 S 1025E State Parcel Number Leea1 Description
OAKLAND CITY IN 47660-7717
26-20-11-400-0 0000.268-001 001-00268-00 PT SW SE 1 AC
ftlnllntlIllnt11u��ul�n t��n tll u� �nl�u��lr ��l ll111 p1
PART 2:TAXPAYER INFORMATION
Owner I st
J o First 1 Middle ,, - ^ La
III Address(number mid strect,city,state,and ZIP code) - - — - - .-_ -' -- I�l.avme as proptrty address -- -- - — —
& 5`3 1 S to - c- r co k/4 n d r , f �.z.--- 976 (0 0
Spouse 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)
Sr
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
unlawfiully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Si tare Date
di
1 /
fit_ -`•D r
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION �.Z WCi
State Form 5473 (R2 15-92)
INSTRUCTIONS: See reverse side for filing instructions. M I AY Q 6 lyy�
• - - (�i CERTIFICATION STATEMENT dd
e) occupied as our principal place of residence the following described Teal roperty for wf 'ch Homestea0 roperty Tax Credit is hereby claimed:
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.
CONTRACT RECORDED '
It buying on contract. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
-
-11
PROPERTY DESCRIPTION
County
Township
Township
Taxing tlis (city town
ownship)
Address umber and street, city, state, ZIP code) -
3 6
Date signed
Otherland
r
Parcel nu
Legal description
,
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.
Residential improvements
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
•eby certify the above statements are true, correct and complete.
Signature 9f7Aaimant
Address umber and street, city, state, ZIP code) -
3 6
ASSESSOR USE ONLY ..
TRUE TAX
.VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL,
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Signature of Auditor
Date signed
Otherland
(2)
Total land (line I plus line )
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 jobs line 7)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
EnK -A
STANDARD DEDUCTION ALLOWANCE
19 _ Pay 19
Lesser of 1/2 Homestead
Valuation or 52,000
S
Signature of Auditor
Date signed