HomeMy WebLinkAboutHomestead_Greene STATEFORM 53569(RJ8p9) TREASURER FORM TS-IAI
APPROVED BY STATE BOARD OF ACCOUNTS,20D9 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FLNA-NCE IC6-1,I-2222-8.1
.IMP 0 ' Al .ROAM=11(9) ' Oiv1 AD _MUMMY 0 r
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
deduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
auses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
s andard 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.
PAR lc PROP •RR YIN 0 RM TION
Taxpayer Name Property Address State Parcel Number Leal Description:
Cary T Greene 304 N Ford 26-12-07-204-003.625-028 NS LOT 1 PT R3
Princeton IN 47670 4
Complete and return to: I1IIODODlDODImIBMIN1Dl00®M UM NI HEM
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2: TAXPAIM INFORMATION
Owner First Middle Last
�/ l __ ( frQEnI�
Address(#umber and street,city,state and ZIP code) Same as property address
Se)ti M . -�& St aNCe itonl N Y767(
First Middle Last
Mating Address(number and steel,city,state and ZIP code) Same as property address
Social Security Number(last 5 digits) Drive's License Sate ID Nunber(last 5 digits) State Other(please speedy in Part 4 below)
• I'AR I$€ER. IFICA 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 f r back taxes and substantial financial penalties.
p
Date
PARTOADI)ITIONAL INFORMAL -
® ILL-
sEP 19 2011
GIBSON COUNTY AUONTON
,,. R,,, ,
a��''„ CLAIM FOR HOMESTEAD PROPERTY TAX
s� ; CREDIT/STANDARD DEDUCTION
a
J.�;• State Form 5473 (R2 / 5-92)
�s�
�m
INSTRUCTIONS: See reverse side !oi liling instructians.
FORM AR,
HC10
. -' - - CERTIFICATIONbu�icm�m �- � . � .
�� �We) � �� certify.tha1q�,a� t Fspt da��r�eh��pt 9
) occupied as our i ipal p ace of residence ihe following described real property for which a Homestead Pro�t7� �x �redit er�py ��imed:
U I(We) owned Are buying under coniract - }�I�nD A5 �Hr� ��
❑ Have a beneficial interest in the entity that is liable for the property taxes on ihe property and that owns the propery�pns �y+Pg•�er.a contract.
It buying On contracf, Fee Simple owner's name
Recorder's oNice where contract is recortletl
Counry
II any portion of the residential sirucmre or
ot the property utilized to produce income.
Coumy
Township � . .
I�egal descnption
Ta<ing
,�r.cn�! CQti!.i•cv '.
Record number
Page
not exceeding one (1) aae that immediarey surrounds that structure is used ro produce income, tlescribe Ne use arM portion
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Township Coun[y
�by certify the above statements are hue, correct and complete.
Address (numberarMS(reet, ary, s(dte, d+P.code) �
\ ASSESSOR USE ONLY - �
Land not exceeding 1(one) acre immediately
surrounding residential improvements.
Other land
Total land (line 7 plus line Z�
Dwelling
Residential improvements
Garage
Other improvements
Total improvements (line 4 through line �
Total value (line 3 pLs line ��
I hereby certify ihe above is true, mrrect, and
complete.
19_Pay19_
Lesser of 7l2 Homestead
Valuation or $�,000
SignaWre of Auditor
TRUETAX I �ASSESSED
'VALUE � VALUE
(�) •
(2)
(3)
(4)
(5)
(6)
I�l
(8)
Sgnature of ASSessor
STANDARD DEDUCTION ALCOWANCE��
S
HOMESTEAD .I NON-RESIDENTIAL
VALUE . VALUE �
Date signetl
Date signed