Homestead_Jenkins -s ? STATE FOAM•3Y+,2i 100 MIASMA 10KM ASIA
ArPRrn'EDBY AtATE onmtoor MYTS\75.2ov rAr Rtan)BY TIM DEPA RTKENr(ftt:strovtLMMiwrFINANCE IC 44.1-_4.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main 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 escr for homestead fraud.Homestead fraud causes higher lax 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 necesmre to allow county government to better monitor homestead
filings.This information will be kept confidential and ran only be accessed by authorized county officials.The Depannent of
Local Govenunent Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Properly Address
Jenkins, John G/Lori A
R2 Hox I I I H O+1A9
Haubstadt IN 47639
3519
John G/Lori A Jenkins
1202E Warrenton Rd State Parcel Number Legal Description
Haubstadt IN 47639-7938
III IIIrrltltttlrrlI irlrr lrrttlrlrtl1111trrltl Ii rtl rlEllrl111 26-23-17-200-001.992-024 004-01992-00 PT W NE 17410.80 AC
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.
Spouse - First Middle Last
� or v s
Mailing Address(Number and street,city,state,and LIP code) ❑ Same as property address
laod t war-re :54 ] K-d 'r-4R0bs -4-4._d -�
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
unlawful) • she Fray-kliable for back taxes and substantial financial penalties.
Owner I v ignature Date
��`�`°: CLAIM FOR HOMESTEAD PROPERTY TAX
i ' CREOIT/STANDARD DEDUCTION
,�
�-��� i' State Fortn 5473 (R2 / S92)
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INSTRUCTIONS: See reverse side lor �ling instructions.
FORM
HC10
YEAR
property and thai owns the proper�DRis Qu71n��r a contract.
� CONTRACTRECORDED � -
If buying on convact. Fee S"unple ovmers name ' � Ty pUDI
G�gSON COUN
Recorders otfice where coniract is recorded � Record number Page
PROPERTY DESCRIPTION
Counry r T ip Ta�c isin �ry, town, townshiPl
SQY7 •
Parcel nu ber Legal cription
�JO - - -�3- % aa- d . - D�
If any po on of e residen structure or the land not exceeding one (7) acre that immediatey sunounds that sinicture is used to protluce incwne, describe the uu and portion of
ihe praperry uGlized to protluce incame.
PROPERTY OWNED BY CLA�MANT IN OTHER COUNTRIES
Counry Township � Counry ' Township
Sig , e ofdaimam
ereby certity the above statements are We, correc[ and complete. ' ,�{
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Atltlress (number and s1ree1, ciry, s7a1e, ZIP code) '
� Z I U =N
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE -
Land not exceeding 7(oneJ acre immediately (��
surrounding residential improvements.
Otherland (2)
Total land (line 1 plus line 2) (3)
Dwelling (4)
Residential improvements
Garage (5)
Other impmvements . (6)
Total improvements (line 4 through line 6J (7)
Total value (line 3 plus line 7J (8)
I hereby certify the above is true, correct, and Signamre ol nssesor Date signed
complete.
Verifying action - Sgriature oi Auditw Date signed
STANDARD DEDUCTION ALLOWANCE
9_ Pay 19 _
Lesser of 1/2 Homestead S
tion or 52,00 �
Signature of Auditor Date si ned
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