Homestead_Garrett STATE FORM!!!M MU YNI nRrASURER FORM TS-IA
APPROVED BY NItIE/CAROM■1I T `AN pnnYIOaEDnv 111E BEYMMENT OF Mal rOVELOItTT FINANCE IT NI-T.1-2.:4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead vandanl deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than net for homestead fraud.Homestead fraud cause`higher tat bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to remise the
benefit and to provide additional identifying infomlamun necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be accessed by autborired county officials.The Depannlent 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 Prole - s
Garrett, Jerry R Trust
R R I Box 52 1/
Fon Branch IN 47648
7649
Jerry R Garrett
308 E John State Parcel Number Legal Description
Fort Branch IN 47648-9708
26-19-18-301-000.238-026 /011-00238-00 HILLCREST 69PT/70PT
PART 2:TAXPAYER INFORMATION
Owner I First 411, Middle Last
tjggi try GA 1t 6t+sf"
.g Address(number and stmt,city,state,and ZIP code)
308 E44t+ SAAgRert, A X7%nN 1tV1 4176f18
Spouse First Middle Last
CAge �hu a4giek
Mailing Address(Number and street,city,stale,and ZIP code) ®Same as property address
303 1451-Sk1qef GV3-02/taicAr/1/ 5e 7418
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
unla 'fully,he or she may be liable for back taxes and substantial financial penalties.
41 I ignaUtrc��� Date
PART 4:ADDITIONAL INFORMATION
s
wun xc io ier�
PrescnbeE By State Board ol Taa Commissioners
CLAIM FOA HOMESTEAU PHOPEHTY TAX CREDIT FOR YEAA 19�_
To & Filed in Dupliwie
SEE BACK FOR FILING INSTRUCTIONS
�We) ���, ��— /C •`� �� certify that on the 1st day of
Tfalrch, 19 _% � I, (We) oceupied a� our principal place of r dence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed: _
I, (We) ❑ owned -. 0�� .�`� Q� 3 j� � ��
❑ are buying under contract
❑ have a beneficial interes in the taxpayer
Property Description in � County � Township
Taxing District (6iFy,
Parcel Number I
If buying Ofl contract: Owners name ��� 5O^o�e owner)
or legal description shown on tax statement:
/d� � >P� ,�- �o ��
Contract recorded in Recorders Office - Record
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
Any other counties in which individual owns or is buying real property: County Township
' her certify the above statement is true, correct and complete.
� C ` -OiC� �i�- •
i namre Str¢et AECreu Giry. State ane ZiD �a
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONIY -
Land not exce g `} (one� acre immediately
surrounding r iaent�l imbrove�s �
E�
Other Land
Total Land ._'��r� � � 1979
Residential Imprqvements
� i �/z�:�.�, -�-
� ��
AUDITOR
Oiher Improvements
True Cash
Value
(t) / O So
(2)
(3) / 0 4 0
Dwelling �4� �
Garage (5) 2 SS 9�
Total �6� �
Tc'�' 'mprovements - Line (6) plus (7) equals (8)
I �._�y certify the above is true. correct. and complete.
Signawre of Asseswr
(�l —
- ACTION BY AUDITOR -
Assessed
Valuation
�
.
jj�j/���j/i
j'f'i::�ia��
�!'�i�.'/�ii
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' • `—�
Homestead
Valuation
F�
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--` U �-� � � � 7%
Daie
Date: �