Homestead_Ames 510E FORM 5.15t.MN Ym M2.SII111 F0KM 71-IA
ArpwretD BY MATE BMRO IrMmt,Tt.9+ PRFYAIBm BY art BFPMFMFNTOF LOCAL GOVERNMENT Fa:A'L4 towia.mat
Gibson County Auditor
101 N Main 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 ever for homestead fraud Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayers 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
filing..This information will he Lrya coati-canal and on only he accessed by authorized county officials.The Dcpanntem 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
Ames, Jamie D
5180E 12005
._ ---- — — — - Hauhsmdt IN 47639
10954
Jamie D Ames
5180E 1200 S State Parcel Number Lethal Description
Haubstadt IN 47639-7909
11111111 trltlltt rr11111111ltrtlltltll11111111111111111111111ii 26-23-13-200-001.858-024 004-01858-00 PT NE 134105.28 AC
D-10
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PART 2:TAXPAYER INFORMATION
Owner I .,\\ First' Middle Last
�Jawt1e- k o )n pme5
tg Address(number and street,city,state,and ZIP code) -- --- — — CR Same as property address - -- - - ----" --
5 I (13o e laoo S }icuc S1zaJ4-, Let 47& 3Ct
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)
sole
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-alsounderstands.that,.by.claiming additional.homestead.deductions _ _
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Ow er I Signatue Date
e� ^'�°; CLAIM FOR HOMESTEAD PROPERTY TAX
s��� CREDIT/STANDARD DEDUCTION
`„ ��.;� State Form 5473 (R2 / 5-92)
uu
INSTRUCTIONS: See �everse side !or filing instruciions.
CERTIFICATION STATEMENT
I: � I i L.�1' �t il
� � �� l�►
i • � . � � .
� � �
�) _ \,(�Kl�l certify ifialorf�g ����4S�fES519 I I
�vve) occupi d s our principal�place of residence the following described real property for which allomestead Property a4c� r i ereby Gaimed:
�I(We) owned ❑ Are buying under contract
Have a beneficial interest in ihe eniity that is liable for the property taxes on the property and ihat owns the property or is buying under a contract.
� CONTRACT RECORDED - -
It buyirg on comract, Fee Simple owner's name .. �
ReCOrder's ottice where Contract is recordetl Record number Page
County
Parcel num er
� ��
I� 3ny POrtion 0� (he fe5idenLaIS�NL(L
of the pmperty utilized to produce inc
/A/il—/T.��
TownsFtip
orthe IarM not
PROPEFiTY DESCRIPTION
Tazi ' trici ciry, town, town ip)
��
one (7) acre that immetlfatey wrrounds ihat structure is usetl to protluce income, deudbe the use arid
ASSESSOR USE ONLY TRUE TAl( ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE �VALUE
Land not exceeding 1(one) acre immediately
surrounding resideniial improvements. (�)
Otherland (p)
Total land (line 7 plus line7� (3�
Dwelling (4) �
Residential improvements
Garage (5)
Other improvements (6)
Totat improvements (line 4 through line � (7)
7otal value (line 3 p6s line 7� (g)
I hereby Gertity the above is lrUe. correGt, and Signature of Assessor Date signetl
rnmplete.
��ng action - Signawre of Auditor Date signed
19_Pay19_
Lesser of V2 Homestead
Valuation or 52.000
S
ALLOWANCE
Da;e