HomeMy WebLinkAboutHomestead_Ayer MATE l ORM 5)5te IIL'/!u'1 M SUID FORM TS-IA
.APPROVED BY MATEIXHRD OF ACCOUNTS."no PRIItRlnln BY TIM DEPARTWYTOFLOCAI GOVEPIMraT FINANCE IC♦I.1-r-RI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuab and married couple.are limited to one homestead sundaxd deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ester for homestead frataL I lomestead fraud causes higher tax bills for all:therefore.
•
HEA 1544-200g 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 gtnemmenl to better monitor homestead
tiling:.This information will he Isept confidential and ran only he accessed by authorized county officials.'IM Dryvnment of
Local Government Finance will use this infonnuion to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Ayer, Larry E
21 I S Madison ST
/ Princeton IN 47670
3317 O \
Larry E Ayer
211 S Madison ST State Parcel Number Legal Description
Princeton IN 47670-2225
X 26-12-08-301-001.402-028 019-01402-00 LYNCH 2ND 132PT/133PT
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PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
,LARRY ELA.geNc Are A
•fig Address(num6cr and street,city,stele,and ZIP code) - - +% -Same as property address —- — --- — -- - .
,z // £ &dIsoAJSt-
Spouse First Middle Last
Mailing Address(Number and street.Lily,state,and LIP code) 0 Same as property address
Social Security Number(last 5 digits) 1 Drivels License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
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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 I Signature
441 g J [hq//L/0'O
I
eE R°, CLAIM FOR HOMESTEAD PROPERTY TAX
s��'= CREDIT/STANDARD DEDUCTION
�;��� State Porm SC73 (R2 / 5-92)
iao
INSTRUCTIONS: See reverse side /arliling instmctions.
r.FanFir.en
�
._) occupied as our princiylal place of �idence thg!foll
(We) owned ❑ Are buying under coniract
❑ Have a beneficiai interest in ihe eniity ihat is liable for
which
the pmperty and that owns the
FORM
HC10
YEAR
�
that o�s�tld�1y1 �t�M�a�rcn. 1�3
Prope cAernt i s7eby claimed:
�ro��aaisbu§'"ing untJec • ntract.
AUD!TnR � '
� CONTRACT RECORDED . -
If buying on contrac�. Fee Simple owner'S name � - . � ..
Recorder's oNice where contract is recorded Record number Page
Coun;y . Tawnship
Pareel number Legal de;
��
I( any ponion ot the r sidential strucmre or the land not
of the property utilized to protluce income. .
PROPERTY DESCRIPTION
_ Ta�cing di5lricl (
one (1) acre that immediately surrounds that stmcture is used ro produce ir�me, describe the use a(M portion
PROPERTY OWNED 8Y CLAIMANT IN OTMER COUNTIES
p Counry
eby certify ihe above statements are true, correci and complete.
Address (numbei anQ stryat, ciry, state, ZIP code) /f
ASSESSOR USE ONLY .� TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL,
VALUE VALUE VALUE VAIUE
� Land noi exceeding 1(one) acre immediately
surrounding resideniial improvements. (�) � --
Other land (p�
' iotal land Qine 7 p/us line Z� (3)
Dwelling (4)
Residential improvements
Garage (g)
Oiher improvemenis (6)
Total improvemenis (line 4 through lina � (7)
Total value (line 3 p�s line � . (g)
I hereby certify the above i5 true, correCt, and Signature oi Assessor Date signed
complete.
'�ng aaion - Signawre of Audiror Dare signetl
� �� PaY � ��
Lesser of 7/2 Homes�ead
Valuation or 52,000
.I SignaWr Autlilor
f~
S
ALLOWANCE