Homestead_James STATE FORM 53569(EMS-I0) TREASURER FORM TS-IA
APPROVED BY SATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6.1.1 22.5.1
• IMPORTANT NOTICE TO'HOMESTEAD PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
abduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
W. 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 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.
PARTI-PROPERTY-IN FORINATION
Taxpayer Name prvnertw Address State Parcel Number Leta Description:
Kurt D Jarnes 3666 E SO S 26-12-I 1-100-001.615-004 PT SW SW 11 2 10 1.4794 AC PT
PRINCETON IN 47670 NW NW 14 2 10 .56 AC
Complete and return to: 0 I l! I: Iltfl ➢ I!p 01 111. Illlf9fil(fI1I30711 icon
- ISLE,lEauO!!L�.�., lmelrz.��•a.�.nJ�a�ga..311i1ia
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
. ' ' . ".::PART 2:TAXPAYER INFORMATION S" _ ;:' . :, :•
Owner 1 First Middle w Last
"D
Matto;Address(number and street_coy,state and ZIP code) \ \_ \,, I Same as property address ) �'7�7
%lo� =04 C�IJ S�'"T-Y \ ���h�,�`�'l -�Vl vI 1'd/O
Spouse First Mode Last
\ Pc\ E avir e
Mailing Address(number anG4treet.city,state and ZIP code) (`-
// , Same as progeny address
) E- 505 . C C' -, LL6'1% -1—n ` 767
.. . .. _. -. • . .
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 unlawfully,he or
she may be liable for back taxes and substantial financial penalties.
Owner G� �Signature Dale
_;
NOV
-81012
C-� O
GIBSON COUNTY
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (8614 -03)
Prescribed by the Department of Local Goverment Foumce
INSTRUCTIONS: See feveroe aids Ar fift m&ucdoro.
I (We) `Y' % IY2 wo4� certify that n- ea�,st caY. / arch. 20
(We) occupied as our principal place of residen a following described real property for which a Homestead Prop €ny T,; Credtt I (r gpgRlaimed:
i)( I (We) owned ❑ Are buying under contract GIBSON COUNTY
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
R.4CT.- RECORDED_' s- � -'��`�..��k?i{'„�',`.,itK,caih� ''IFS ?���•',.,..;';;��'*�.:
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
�f'. PRORERTY,6WNEDFBY'CLAIMANT'IN OTHER' COUNTIESf- +.-s.,°.?`-,„K,.'s'- -Jie�'3
�.
14OPERT.Y :DESCRIPTION 7��' `' „rj;: t z',�',°.,."''",f"t '; ,�,:� sm'S�`�_Z �3? z_•_` s"fy^?4.,'s ?.
Count
Township
' ad umber and street, dry, state, ZIP e)
Ta+dn mct (Ci , town, to )
Signature of Auditor
t'=r =p sxY.$a
�ASSESSOR,USE ONLY ,.s, -
TRUE :TAXI s
ASSESSED'VALUE
P //��((��C //c��pnu r �� r�/�
escri on
�1
Is the pro ny in question:
(,L(% W
ll-,;2 —/
Real property ❑ Mobile Homo (I.C. 61.1 -7)
any pro ier of the recto structure or the land not exceeding
one (1) am that immedatey surrounds that re is used to Produce income, describe the use and portion
o
of the property uWized fD produce income.
prod)
�f'. PRORERTY,6WNEDFBY'CLAIMANT'IN OTHER' COUNTIESf- +.-s.,°.?`-,„K,.'s'- -Jie�'3
County Township
County Township
I hereby certify the above statements are true, correct and complete.
Si nature o aims
' ad umber and street, dry, state, ZIP e)
a 52K 0:15 a q7L 76
Signature of Auditor
t'=r =p sxY.$a
�ASSESSOR,USE ONLY ,.s, -
TRUE :TAXI s
ASSESSED'VALUE
HOMESTEAD
' fNON= RESIDENTU\L
�e ��
�1
'.s�VALUE
AT 100 /..OF�TN�
.
-Yar;VALUE��"s
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
�;w:s -.HF;r iearr�
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
W,:.ur� dx�
Residential improvements or Annually
Assessed Mobile I Manufactured Hero
Garage
Other improvements
(6),,�ir`
Mvie✓C�. �V' �4
K - T
Trial improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
5T/WDARij DEDUCTIONIALLOWANCE�.r^�E. . >is''„`Y°, ? -' a�l!'�•i. -Wl 7?� •.v-.
20 _ Pay 20
Lesser of 112 Homestead
$
Valuation or 535.000
Signature of Auditor
Date signed