HomeMy WebLinkAboutHomestead_Hathaway (3) STATE FORM 53569(R2R-09) TREASURER FORM TS-IAI
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE ICS-1.1-2222-8.1
re IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
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
Oauses higher tax bills for all; therefore, HEA 1344-2099 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.
PAR'I'l: PROPER Y INFORMA ION •
Taxpayer Name Properh Address State Parcel Number Legal Description:
Wilma E Hathaway 907 N Second ST 26-12-06-303-001.110-028 019-01110-00 PARKVIEW
Princeton IN 47670 IPT/2PT/27PT/28 BLK I
Complete and return to:
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2:TAXPAYER INFORMATION
Owner) First Middle Last
Imp akk i
a
MaiEng Address(number and street,abr.state and ZIP cede) [ property same as propy address
Sowwse First Middle Last
Mailing Address(nurrta and street,city,state and ZIP code) Same as property address
Social Security Hunter(last 5 digits) Driver's License State ID Number(last 5 digits) State Other(please specify in Part 4 below)
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 Date
( )
PART 4: ADDITIONAL'LYFORMATION
•
J
e� ''3 g CLAIM FOR HOMESTEAD PROPERTY TAX
;���: CREDIT/STANDARD DEDUCTION
� State Form 5473 (R2 / 5-92)
iaii
INSTRUCTIONS: See reverse side lor tiling instructions.
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FORM
HC10
YEAR
1(We) _` _ certify ihat on ihe ist day oof March, i9_
I(We) occupied as our principal place of residence the following desc bed real propeny for which a Homesiead Pr�Y Ta� Qeae9�reby claimed:
r ir�+
�'�We) owned ❑ Are buying under coniract �oI�
ave a beneficial interesi in the entity that is liable for ihe property taxes on the property and that owd�� o�iShJying under contraci.
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. �� � CONTRACTRECORDED �
I( buying om m�traa, Fee Simple owner's name � � - . -
Fiecorder's office where contract is recorded Record number Page
� PROPERTY DESCRIPTION
County Township . Taxing district (ciry, (own, township) �
Parcel number Legal descr 'on �
—�IllO -Oc�
It any portion of the residential strucNre or Ne lantl not exceeding one (71 acre thai immetliatety s�rmunds that swcmre is use to pm
ot the pmperty utilized :o protluce income.
income, desaibe Ne use antl portion
PROPERTY OWNED BY CLAIMANT�IN OTHER COUNTIES
County � Township Counry Township
II hereby certify the above statements are irue, correci and complete. Signa;ure of Caimam
�=55 (number and sneef. ury, sta(e, ZIP cnde)
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE �VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvemenis. (�)
Otherland (p)
Total lantl (line 7 plus line 2� (3�
, Dwelling (4) �
Residential improvements
Garage (5)
Other improvements (6)
Total improvements (line 4 fhrough line � (7)
Total value (line 3 pt�s line 7) (g)
I hereby Certity Ihe above is lrUe. Correct, and Signamre ot Assessor Date signed
complete.
Verityin9 acnon - Signature of Autlitor Date signed
19_Pay19_
Lesser of 1/2 Homestead
Valuation or 52.000
DEDUCTION ALIOWANCE
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