Homestead_Malone •
STATE FORM 53569(R3/8.10) TREASURER FORM TS-IA
APPROVED BY STATE Y.OARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1.32-8.1
• 4'. IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS ,' _ : ,i a4
• ?•3
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
�
duction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
_NI!!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.
c' g4k 1, -I•. :T PAR I["PROPER V INFO'MA ION' . i.
Taspaver Name prooert-Addresf State Parcel Number Leeal Description:
Kevin L/Stephanie E Malone 3921 E 175 S 26-12-23-100-000.177-004 PT E NW 23-2-10 1 AC
FRANCISCO IN 47649 - D-10
Com _73a EEODa LOUOU]DRM1IHIHO1000OmmimHHO]UOOO
t..e.e.. �return 4::
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2: TAXPAYER INFORMATION • , J-4 i;
Owner 1 First Middle Last
Matting Address(number and street,city,state and ZIP code) (
V)/gyne as property address
spouse - First Middle Last
to a h'1 Io " 42--
Mailing Address and street.city,state and ZIP code) ame as property address
•
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 1 Signature Date
_;'.
rib
" IL
NOV 32012
GIBSON cuuren' A'J -"
CLAIM FOR HOMESTEAD PROPERTY TAX R e YEAR
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 15 -92) I
INSTRUCTIONS: See reverse side for filing instructions. MAY 10 1996
I (We) �= v -- _ _ _ _ / y that on"W..kE%,"arch, 19
I (We) occupied as our principal place of residence the following described,real property for which a Homestead Property Tax Credit is hereby claimed:
�®I (We) owned El Are buying under contract _
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.
CONTRACT RECORDED -
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
'
PROPERTY DESCRIPTION
County
Township -
Taxing district (City, town, township) -
Pgrcelln n her
Legal descriptio
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income. describe the use and portion
of the property utilized to produce income.
- lea 1-5-2?6_ AD -660. -QG�
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township County
Township
I hereby certify the above statements are true, correct and complete. Sig .Or of claimant
®Tess (number and street. dry, state. ZIP code) -
O
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2.000 S
Signature of Auditor
D09
Other land
(2)
Total land (line I plus line Z)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 phs line 7)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
verifying action - Signature of Auditor
Date signed
.-
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or $2.000 S
Signature of Auditor
D09
Date signed
0-
.-