Homestead_Robinson (6) STATE FORM 535tH(RA/840) TREASURER FORM TS-IA
APPROVED BY STATE.BOARD OF ACCOUNTS.IDW PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC 61.1-359.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
Pflnceton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher lax bills for all;therefore,
HEA 1344-2009 requires taxpayers who receive the homestead stardard deduction to verify that they are eligible to receive the
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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 be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY NFORMIATION
MAY 5 2011
Taxpayer Name Location Address
C.J.nw y
'Robb, Eddie C/Alice L Trust Life Est.
v cv\ 503 N WEST
GIBSON COUNTY AUDITOR
FT BRANCH IN 47648
6924
Sheila Rae Robinson II�I01111[III III I VIII [III��II�II]ILl�I [II�II
503 N West St II_III[IIII�I I�II_�II�II01[II[III
FORT BRANCH IN 47648-1045
1111�Itllll"Ill"' "II'I'IIIllllllll'lll'll'llllllllltl11111111 State Parcel Number - Legal Description
- 26-1&13-401-000.656-026/PT-W_SE_13,317_269AC,
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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.
- - 1 ,---l--T-�"--------- PART 2: TAXPAYER INFORMATION 1
1 First Middle - Last
A
Mailing Address(number and street,city,state,and ZIP code) Q.Szme as property address
S-0 3 N Gv. .<M -0m . c/7K sz 7 /a ct _s-
-
Spouse ' First Middle - Last
Mailing Address(Number and street,city,state,and ZIP code) 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)
I I I I I I I I slate
PART 3: CERTIFICATION
Each undersigned certifies,tinder 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
U
"'^ CLAIM FOR HOMESTEAD PROPERTY TAX Fo� Y�t
STANDARD I SUPPLEMENTAL DEDUCTION
° stateformsa73(Rt2�c-os) . � HC70
�' / ares�ced ny u,e o�rtmeM ��oc�i co�mmem F�� ,
INSTRUCTIONS: See raverse side !or filing instructions.
� M'e) �'/( �,� E� .(,! // li(1/�i j�(�i.��fts 1 certify that I(we) occupied as my (our) principal
place of residence or am (are) buying the following described reai property for which a Homestead Property Tax Stan��lleipcUpp jg hereby daimed
under conVad on the date lhis applicatlon is filetl, (dafe o!filing): a � C U 1 I
❑ I(We) own ❑ Am (are) buying under recarded conVact C.�.IV�
❑ Am (are) en6tled to occupy as a tenant-stockholder of a coopera6ve housing corporation �
� Have a beneficial interest in fhe wst or Ihe right to occupy the property under Ne tertns of a qualified(�pFEB@jU�q�aqyµ��,�,r�_
Dmmfs firnnse / larnti!ka;ion /
of tlaimam (last frve a"giGSJ
of daimanYs spouse (las!
If Miying rn contraq Fee Simple ovmers �me
ReCadels otfiCe w1ieR mntraG 6�etdded
Counry
Tawnship
Legaldesaiption
fo-1 - J -WV. J(�- b
�R any portion W tha 2sdenUal sWCLira oi Ne W�d nol exreed'ug orre (1) acre Nat immediately s
of ihe prope�ty �mlfzed m proeure uwome.
.�• • �:
Caunry 7ovmship Counry
I hereby cenify the above ststement5 are We, cortect and complete. S;n'
a LPCOd
�- . t 13fa.ncF� , ��"
LanA not exceeding 1(one) acre immediatety
surtounding resitlential improvements.
Other land
Total land (line 1 plus line �
Resldenllal improvements or Mnualty �����9
Assessed Mobik 1 ManufacWred Home Garage
Other imp'ovements
Total Impravemen� (Ilne I fhrougAfine �
Total value (llne 3 plus line 7)
I hereby certify the above is we, cortea,
and complete.
VWying aaon - Sig�n�re of �tar
(�)
(3)
(<)
(5)
(6)
18)
Is
Iswitg State
Remrd rwmEel
rown,
D�P�Y in W �Gm:
�eal propr.rty � MnuaOy assessed modle Mme (IC 6f.7-n
inat structure is used m praduce inoome, tlescnbe ihe use and pation
20 _ pay 20 _ Lesser ot 60% of the assessed value of Ne homestead or $45,000
NoMilASIeM'ug enyWherpmvision, Me sum o1 the deducfions pro�itled in IC 61./-1210 a mo6rle lpme Naf k
not acsstted es real prope�ry a ro a menulectwed hortie Ihaf 'a nof essessed as real properry mey not ermeE
meha/I /121 N Ne assessed velue W Ihe mo6de hmie wmanNarluretllrome.
$
Township
oa�e sgnea (�m,m,. aar, r��
