Homestead_Mounts .. STATE FORM 33'w.IR_I s tt 1 LSTJL R FORM:S-IA
.VFFFED BY AVE BOARD.*MnhiNIS.SIN PRESCRIBED BY THE DFFARINEYT OF LIXALOOVERNNR3 FIANCE w i.t-r-t.,
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
N Main
I I 71 r Individuals and married couples are limited to one homestead atandaN deduction.As the receipt of this deduction becomes
1 p more beneficial.there is more incentive than tier for homestead fraud.Homestead fraud causes higher tae bills for all:therefore.
® ,( HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recebe the
��// benefit and to provide additional identifying information necessary to allow counts'government to better monitor homestead
APRHuss.This information will he l.rpt confidential and ran only he accessed by authorized county officials The I)epanman of
2 3 2010 Local Broemment Finance will use this information to create cols that will help county officials eliminate homestead thud.
PART 1: PROPERTY INFORMATION
7a.5,e, Taxpayer Name Property Address .
GIBSON COUNTY AUDITOR Mounts, Larry J/Monica
R I Box 166 0 j
Fort Branch IN 47648
3017
Larry J Mounts
424E 780 S State Parcel Number Legal Description
FORT BRANCH IN 47648-8006
(11n11ut1111ur1n 11n111n1111nt11nu11nn11111u 1u 1111 26-19-19-204-001.283-026 007-00993-00 INDIAN HILLS a1
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.
f
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
�ac c y 50e h1ouYs"\-'S
its Address(number and street,city,sate,and ZIP code) ❑ Same as property address
Strew poSAA xa
9.0.6t3-( 310 vkac-1 E r\2bs 1 Val Qraneln 1 `-17b`R
Spouse First Middle Last
Y\ClN\S CA— N\b„k-S
Mailing Address(Number and street,city,state,apd ZIP cudel ❑ Same as property address Qk NO
?.0 ,\50--/ 36 yak; - ri80s ) �oR-N -o c_■()iIN UlbLk9
. r-V. `,f-' PART 3:CERTIFICATION • • • '
Each undersigned certifies,under penalty of perjuy,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 S' true Date
-
CLAIM FOR HOMESTEAD PROPERTY TAX ��R YEAR
CREDIT/STANDARD DEDUCTION FHC�o
`° � s� r-o� se�a �e � �-o» r;
Prescnbetl by Ihe Departmem of Local Govemment Firance � .. �
$
INSTRUCTIONS:Seereosrseside/orfifirn�ms6uctions. u�L 2 y, Z008
_ , � ,
—fi,,� �
��e) � rtity tlial on [he��s���Tda�y p�20_
I(We) ocwpied as our p� a I pl of residence Uie followinq described real property fw which a Homestead �ao�e�iT�t��;2aYt is hereby daimed:
L _ G
� owned U Are buying under contract
a benefidal interest in fhe entiry that is IiaWe fa Uie property taxes on the property and that owns the property or is buying under a contraG.
I! Wye�g on oonUaG, Fee Simple avmars rmme
Recordefs offica whe�e canract is
Counry
Tavnship
fownship)
Record number � Page
Parcel number Legal n tion U� � rty in quesGon:
� n'f�`�� �� � eal property ❑ Mobile Homa (IC 57./-n
If any pwtion of Ure residerNal sWCWre a the Wnd nd exceedirig one (t ) acre Ihat im�ateAy w nds Ihat sinxture is used b produce inwme, descnDe ihe use aM portbn
ot Ihe proparty uliGzed m p�oduce inmme.
a�-�9-�9a��;a� �93-oa�
_,�_,�_�,.,T_
._ . . . .. . .
,, . �
Land not ex�ng 1(one) aae immediately - ��''�. _ �
.x s. , -:�
surroundirgresidentialimprovemenis. (�1 . !�;�.;';� �_ .
Othet land �2) � r' ",�;. . �••z ._
Tdal land (line 1 plus Gne 2) �g)
DweOirg (q) � = - .
Residential imprwements or Mnually
F�ssessed Mobile / Manvtaclured Flarre . . . . . . �
Garage �5� . . ,
Other improvements (6) . .
Tdal improvements (line 4 through line 6) �7�
Tatal value (line 3 pl's liire n (g�
I hereby tertify Me above i5 We. correCt. and SignaWre ofASSessor Date signed (monN. day.Yea�
complete.
Vsifying adion - Signature oflwditw pa�e signed (rna�N. day, yeah
cv y�_ pay cv v� qs,ppp for 2007 pay 2008 42,000 for 2010 pay 2017
Lesser of 12 qq,000 for 2008
H«nestead Valua6on PeY Z009 41,000 for 2077 pey 2012 $
« 43,000 for 2009 pay 2010 40,000 payable after 2012
Date signed (manfh. daY• Y��