HomeMy WebLinkAboutHomestead_Bruce (5) STATE FORM 53569(53/5-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.14241 I
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Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
r �luction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud.
'Pauses 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.
PROPERTY INFORMATION l�V 4.
Taxpayer Name Property Address State Parcel Number Leal Description: V
Jeffrey A Bruce 313 S RACE ST 26-12-07-401-000.272-028 PT SE 7-2-10 .17 AC
PRINCETON IN 47670
Complete and return to: I1111u001I1lH] thI010m10 IMEMQ Dl1Ill
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
.. .. PARTS:ITAXOPAYER INFORMATION - .
Owner First Middle Last
Matting Andress(number and street,city,state and ZIP cede) Same as property address
Spouse First Middle Last
Mailing Address(number and street,city,state and ZIP cede) Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number(last 5 digits) slue Other(please specify in Pan 4 below)
.74-. PAR 3: GER IF,ICAA ION =..
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 1 Signature Data
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44;7'1- PART el ADDITIONAL INFORMATION _ _
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fwm 5473 (R2 / &92) ,
INSTRUCTIONS: See reverse side for /iling inshuctions.
� FORM
HC10
YEAR
CERTIFICATION S ATEMENT
I(We) certify that on the 7 st day of March, 19_
I(We) occupi d s o � cipal pl of residence the following describe r al property tor which a Homestead Property Tax Credit is hereby claimed:
❑ I(We) owned ❑ Are buying under cont2ct
❑ Have a beneficial interest in the entity that is Iiable for the property taxes on the property and that owns the property or is buying under a contract.
- CONTRACTRECORDED �
If buying on conVact, Fee Sunple owners name
Recordefs office where wnvad is recorded � - Record number Page
PROPERTV DESCRIPTION
Counry TownsNp Taninq districi (ciry, tmm, lamshrp)
P� nu ber �� � Legaltlescription � — �
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It any portion of Ihe residen6ai sWCture or the land noi exceeding one (7) acre that imm�ately surtounds ihat swcture is used to produce income, describe the use and portion of
ihe property utilized to protluce incame.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry TownShip - Counry Township
na e of claimant
�ereby certify the above statements are true, correct and complete. rZ _
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Address (numbera s e ciry, state, ZIP "
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ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTtAL
_ VALUE VAWE VALUE VAWE
Land not exceedin9 1(one) acre immediately (� �
surrounding residential improvements.
Otherland . (2)
Total land (line 7 plus line 2J (3) �
Dwelling (4)
Residential improvements
Garage (5)
Other improvemenis (6)
Total improvements (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify [he above is true, correct, and Signature oi Assesor Dare signea
complete.
Verifying action - Signature ol Auditor Date signed
� - STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead �
Valuation or 52.000
Signature of Auditor Date ' ned