HomeMy WebLinkAboutHomestead_Seifers STATE FORM 5350(RS/&lo) TREASURER FORM TS-1A
APPROVED BY STATE BOARD OF ACCOUNTS,MP PRESCRIBED BY TIIE DEPARTMENT OFLOCAL GOVERNMENT FINANCE IC 6I.I.IIAI
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
'Princeton, IN 47670 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
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
IF,� - Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
1,1��\IIr PART 1: PROPERTY INFOR?L4TION
Taxpayer Name Location Address
APR 0 7 2011 Seifers, Rodney D/Synthia
. 4222E 200 N
C•Wn PRINCETON IN 47670
l o COUNTY AU0 TOR ii ifluII_�II 111 I_�IIIIWI I_selll�l�ll_I o iuII�11111�I.II I IDII�I�IIDII�i II II
Rodney ney D D Seifers
4222E200N
Princeton IN 47670-8933
111111'1'11111111'IIIIIIIIIIII'I'"'I1�1111I111I'1111111I'IIIIIII State Parcel Number Legal Description
26-05-35-200-000.651-004 /Sw NE 351 10 9.92 AC C-1 D-7
A J
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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.
PART 2: TAXPAYER INFORMATION
or First Middle Last
Mailing Address(¢ • and street,city,state,and ZIP code) Imo amras property address
-
1fa?26- ;co N i ��e � Si V7670
Spouse, First Middle Last
sykfi _t� L-, -se i rCrs
r _.-_�
Mallm Address umber and strut,cl state.and ZIP code - -. .-_ _" — - adaess
g tN h. �_ properly - -- --.,-- - - ..— _ -
—
/722ZE <2oo1V gin 01/9 (r ' 97670 ,
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
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner Signature ,,D �//
CLAIM FOR HOMESTEAD PROPERTY TAX
s, CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 15-92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
•. - - ' :CERTIFICATM STATEMENT'' rA1f -1(�lq
I (We) certify that ot� t 4 11 day t1ti�A8rch, 19
1 (We) occupied as our principal pl ce of reside a the following described real property for which a Homestead Property Tax Credit is hereby claimed*
I (We) owned ❑ A buying ur cantract /' I, /
J Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property, of ,; tiuying undefa ?cdntract.
< ..
CONTRACT RECORDED,% ;
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
. -
PROPERTY DESCRIPTION s °'--
Coun
Township
Township
Taxing dis (city. tow t. tcwnshi
Parcel number
oa - -006s/-CD
Legal description
W CIE 3S - -io a PC-
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that stucture is used to produce income, describe the use and portion
of the properly utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
s5ztV91aimant
111wress (nu street, city, sfa . ZIP code) _
7jo� 3ZS' 10.0c -tom T O
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL:
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
-
surrounding residential improvements.
(1)
'
Otherland
(2)
Total land (line 1 plus fine 2)
(3)
Dwelling
(4)
.x -
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(g)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
verifying action - Signature of Auditor
Date signed
® -
- STANDARD DEDUCTION ALLOWANCE-"
19_Pay19_
Lesser of 1/2 Homestead
S
aluation or $2,000
Sign u of Audit
Date