HomeMy WebLinkAboutHomestead_Bush SATE FORM 53569(R3/3-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE 106-1.1-22-8.1
MIND 94 4 WNO 1C« ,.= 0" Z �) ' e•Oa •. Y 0WN RS
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
Sauses 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,
. ll'�V3UtJe ' c ` �' [h[,�Co1; 1011oBJ
Ta',paver Name Property Address Slate Parcel Number Leal Description:
Stacy Ann Loveless 506 W MONROE ST 26-12-07-303-004.176-028 RICHLAND FOREST
PRINCETON IN 47670
Complete and return to: JuIIimEMfluII]F IIIIFllunh!.!IdIuIHI,!IIIIIMIJDMMIlI
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
.-- MEW 9344 XPAr1IINFORMATION .
Owner 1 First Middle Last
S4� Ail
Mating Address(num and street,city,state and ZIP code) I I/
��qq//�� ✓name as property address
ie First Middle Last
Mating Address(number and street,city,state and ZIP code) I Same as property address
Social Secuny Number(last 5 digits) Driver's License/State ID Number(last 5 digits) Eras Other(please specify in Part 4 below)
PATRT 3: ef:RTI FICaTION '
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 s�ubbsssttannttii7al financial penalties.
Owner 1 Signature l����Y��y�-f Date
( )
PARTd ADDITIONAL INFORMAL - . •
FILED
illt DEL 3..1 'ZUTZ\\
L. .1f v V
Gtb3ON COUNTY AUDITOR '
�; CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDITISTANDARD DEDUCTION
/ Sute Fwm Sd73 (R6 / M3)
Prescribed by t�e Department of local Govemment Finance
INSTRUCTIONS: See revcrse side !orllinq insfrtic(ions.
FORM YEAR
HC10
�� T.
�' �� ��
I(We) � � certity ihat.on the 1st day of March, 20
I(We) occupied as our principal place oi residence lhe wing desrn ed real property for which a Homestead Property Tac r`dii is heieby daimed>n
� I(VJe) owned ❑ Are buying under contract '�'�`"� "'`� � �
� Have a beneficial interest in lhe enGty that is liable for the property laxes oa the pmperty and that owns the property or is buying under a wnVaU.
If buying am m�trad, Fce Simple ownefs name
Recordefs afice where conVaU is recorded
�� ���� .� c t E�' � i ' ,� i i ��' :' i �? � �
Counry ' iamship
�
H any poAion of the residenllal sW cNre w the
ot Ihe properry WGZed tn praduce inmme.
Record numEer � Pa9e
Tating disirict (�ty, (own. townshiP)
S%�6,pn � I Is the pmP�Y in question:
J ❑ Real DroPertY ❑/Aabila Homo (I.C. 67.7-7�
exceeding one (1) aae that immetliatey wrrounds that sWChue is used to produce income, describe the uu and portion