HomeMy WebLinkAboutHomestead_Lanham STATE FORM')564(R)/8-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.tpq • PRESCRIBED BY THE DEPARTMEA1 OF LOCAL GOVERNMENT FINMA'S=bl.t-:SA.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud Homestead fraud causes higher tax bills for all;therefore.
HEA 1344-2009 requires taxpayers who Ict ive 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.
PART 1: PROPERTY INFOR_\IATION
Taxpayer Name Location Address
Lanham, Daryl R
1001 E Broadway
Princeton IN 47670
3358 -
Daryl R Lanham
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1001 E Broadway -
PRINCETON IN 47670-1925 •
IIII�III"IIIIIIilllllllIiIis�I�llll�rlllllIIIiIiIIiiiIIiiIiillll State Parcel Number Legal Description
26-12-08-301-001.675-028/HIGHLAND HOME 45 PT
This form MUST be returned to County Auditor's office.
Please.do NOT send this form back with your tax payment to the county treasurer.
_ — -------_)ART2_TA\PAYE' INFORMATION
Ow..,.. I First Middle Last
/, I gy L on l, qh,
Mailing Address(number and street.city,state,and ZIP code) go Same as property address
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
—I I—I-1— I—I _ _I—! --I-- 5. - - - ---
PART 3: CER:IFICAT'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 maybe liable for back taxes and substantial financial penalties. - -
Owner(.SrRna 1 / Date/
y Phone 17 v. n- !r- Ynr F'4n: 17 el pr:in 'f
•
x CLAIM FOR HOMESTEAD PROPERTY TAX
" CREDIT/STANDARD DEDUCTION
t � + � � StaU Fortn SC73 (R5 / 7P07 )
��� Presaibed by ihe DepartmeM d Local Govemment Finance
INSTRUCTIONS: See reverse side lor (ling instructions.
FORM
HC70
���
YEAR
�(�'�e) � �/ certify t on the 1sl day o( March, 20
I(We) occupied as our prindp ace of residence the (ollowing described real pmperty tor which a Homestead rty T it'� ereby ime �
�] 1(We) owned ❑ Are buying under contracl " GIBSON COUiJ7 y qUD170R
� Have a benefidal interest in the enUty ihat is liable for ihe property taxes on ihe property and thal owns lhe property or is buying under a contraU.
If buyinq om m�Vacl, Fee Sunpie owners nama
Remrders afice where conVaC is recwCed
Counry
If any
of Ne
County
Twmship
Legal
of Me residmtial sWCWre or Me IanG
y u6lizetl b produce income.
Tavnship
Record number � Pa9e
Tating aisVict (dry, town, township)
Is �he O�DanY in ques6on:
❑ Real D�aPeM ❑ Mubile Hano (I.C. 6/.
one (7 ) acre Ihat immediatey wrtounds that swcwre is used b produce inoome, desaibe the use and pwtbn
I hereby certify the above statements are We, wrred and complete.
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r .�; '� � -+.c.�--' . �4 " . _ �.�:.� -•y- • w
�` ���` �'�'i''� "��� '��,�� -'��'. �TRUET/U( } �ASSESSED VALUE HOMESTEADi� NON=RESIQENTULL '���
ASSESSOR!l1SE ONLY -f - z �+. �:+� r ,:� Y
�i: .��. �.2�'�'��t.�."�'•�.. - � ',..� i'�.Y-/1L.UE..K�..st hATa700%�OF,#.m-� �:VALIIE� � .,.. �.:...'i�,YALUE��.�' '_
Land not exceading t(one) acre immediatey � ���' ?�z,' .,,, r`�:'%j'��
surtoundingresidentialimprovemenis. ��� �j���'„��g`� xf{�'�`.�.�.
Other land (p) :��'w�}b����: .
Tdal land (line 1 plus line 2) �3�
� �rr^ Y's-rF ��
Dwelling (4) �'�,.-��'��� "Y' •'`�'"8-�.t.�.
Residential improvements „ s w�
N� �
Garage (5� � �` <.,z�s�°M^ �
�5�4�+"�°'.a y. - 4
Other improvements (6) : ��A����{
?; � �. � e. �-�
Tdal improvements (line 4 through line 6) �7�
TUaI value (line 3 phs line n (g)
1 hereby GeRi(y the above is We, coned, and Signature ofAsussor Date signed
complele.
Veriying action - Signature oflwditor Date signed
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