HomeMy WebLinkAboutHomestead_Hester STATE FORM 53569(R3/8-10) TREASURER FORM TS-IA
APPROVED BY.STATe BOARD OF ACCOUNTS,3009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1-22-8.1
' 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
Or Or uses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
d dard 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.
PARTI: PROPERTY IN ORMA ION .•
Taxpayer Name Property Address State Parcel Number Lent Description:
Anna Geraldine Hester 1906 NORTHWESTERN AVE 26-12-18304-001.166-028 BROADLEIGH PARK 112/111 PT
PRICNETON IN 47670
Complete and return to: IRMIMIMMIREMIADE1011111111MEEREIMIE111
•GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 •
PART 2: TAXPAYER INFORMATION . -' . _ . . .- .
_ . .
Owner 1 First Middle Last
/ c r,r-.r .0 C e, Q v-oAcA\ Y, 11.-Ae.' Ac v—
Mailing Address(number and street city state and ZIP code) same as l>uPam address
``
Mating Address(number and street,city,state and ZIP code) Same as property address
Social Security Mmber(last 5 digits) Drivers License/State ID Nutter(last 5 digits) state Other(please specify in Part 4 below)
- 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.
O.wer 1 Signature Date
( )
PART 4: ADDITIONAL INFORMATION
FILED
MAY 3.1 20`12
GIBSUN COON I Y .out I OR
eE.Rm
s CLAIM FOR HOMESTEAD PROPERTY TAX
y��: CREDIT/STANDARD DEDUCTION
�..,�.�'� State Form 5473 (R2 / 5-92)
�so
INSTRUCTIONS: See reverse side lorliling instructions.
FORM YEAR
HC10
���.A��
i��^re� �.l n(1� ( � 1� QS 42.t' �emry rna � me i 5r aay oi y� «n, is_
�) occupied as our principal place o( residence ihe following described reai property for vihich a Homestead Pr rty Ta�c re is b eby d- ed�
LI I(We) owned ❑ Are buying under contraci C-IB:ON CnU,. Y AUOITOR
❑ Have a beneficial inierest in ihe entity that is liable for the pmperty taxes on the property and that owns the property or is buying under a contract.
� � � CONTRACT RECORDED - - - - �
I( buying on contraa. Fee Simple owner's name . � -
Recorder's ottice where cornract is recorded Recortl numDer Page
number
ot
Tmvnship
7�—O (� ���a� �C�t. Ci � 2� c� h
�.itlential strucmre or ihe IarW not ezceetling one (7) acre tha imrt
to protluce income.
J
(rity, tavq rownship) � '_ . ' _
�
k- I a l l��'
Is lhat strutture is used to rotluce income, describe ihe use antl F
� PROPERTY OWNED BY CLAIMANT IN OTHER COUN'T�ES �
COUnty � TOwnShip Coun[y TownShip
�eby certify the above statements are true, correci and complete. Sig�n re ot ciaiman[
Addr s numbe�andstreeLdry,state.ZlPCOCe)
ASSESSOR USE ONLY . TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTtAL .
VALUE � VALUE VALUE VALUE .
Land not exceeding 7(one) acre immediatety � �
surrounding residential improvements. (�) ��
Otherland (p)
Total land (line 7 plus line 2� (3)
Dwelling (4) �
Residential improvements �
Ga�age (g) ' � �
Other impmvemenis � (6) - -
Total improvements (line 4 through lina � (7) I
Total value (line 3 p�s line � � (g)
1 hereby certify ihe above is irue, correct, and , Signamre of Assesmr Dare signed
complete. �
���•,�yirg action - Sgnanre of Autliror Date signetl
- � � STANDARD DEDUCTION ALLOWANCE � �
19_Pay19_ I
Lesser of 7/2 Homesiead
Valuation or 52.000 S
yn wre of Auditor '� Date si etl �� ��
' ' . -_ -. _ .---- _— ._ �
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