HomeMy WebLinkAboutHomestead_Hoskins STATE.FORM 53569 LAT/7;09) TREASURER FORM TS-IA
APPROVrf.9Y STATE.BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OE IOCAI.GOVERNMENT FINANCE IC 61.1 22-9.1
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 causes 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 indentifying 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 INFORMATION
Property Address(number and street,city,state,and ZIP code)
oai , c - .• J XI 714 e ! {
State Parcel Number
2- /0 3 - ) 7 - 303 606 Ooa 003
FnnE''B9 2015
GIBSON COUNTY AUDITOR
PART 2:TAXPAYER INFORMATION
Owner I First Middle /`/l fj Last
ficis!I� Mailing Address(number and street,city,state,and ZIP code) lig 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)
State
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.
Owner 1 S. a t ey Ate Date 6
PART 4:ADDITIONAL INFORMATION
DL
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I
INSTRUCTIONS
ti
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Stift Forrri 5473 M7154M
Preamribecl by the Departrnant of Local Govmmwt Fx
INSTRUCT70NS., See reverse side for rdhig instructions.
" W!x ji, lm�:
I (We) ( Ig"
, certify that 1 st 0 4afch. 20__
1 (We) occupied as our principal place of residence the following described real property for which a Homestead arty t iso&,eby claimed:
m�'
I (V*) owned 0 Are buying under coritract GIBSON COUNTY AUDrMR
Have a beneficial interest in the entity thad is liable for the property taxes on the property and that owns the property or is buying under a contract
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CT,
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Fee Sffnpde owner's name'.
paocrows Of5ce where civitrad is ream Record number Page
-1: wzl '1FWROPERTY0ESCVdPTI0W-'*'
A-
County
courity
Timartship
-ra" district (mly hoar, township)
I hereby certify the above statements are true. coned and cornplete.
Parcel number
Lao descriptim Is the prop" in question:
lDale signed
'!4A472
4 ❑ Real property
❑ WWI. Harris (LC. 61.1-7)
114M potion of the resiclenfial sbucture or the Land nafexceeding one (1) amn, dud mrnedialmly surrounds drat sbixtura is used to Produce imxxne, desm-be the use and porbm
Property Wimd 11) produce incorne.
13 - 17 , 30,311 - 000. 0 vat -OOS
JAT.100%:OF TTV:-
A.
County
Ship
courity
Township
I hereby certify the above statements are true. coned and cornplete.
Maim
ber and frue date, GK'S 'S RANC,150, IN q7&q')
lDale signed
ONLY e'
As�o"IWdg
tl�.--IIIIEESTEAD V
'-�,V'-'�VALUE
"*"!� IAL
�';NONMTSEM
VALUE: x
JAT.100%:OF TTV:-
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Land not exceeding I (one) acre inirriedately
surrounding residential irrprovements.
Other land
(2)
Tdal land (Ikm I plus &m 2)
(3)
Dwe lling
(4)
Residential kromm.vnts or Annivally
Ga rage
(5)
Assessed Mobile- I Manufactimad Horne
4
e 'w
Other improvernerits
(6)
Trial aWrovernards (Fine 4 MmLgh Erie 6)
(T)
Tdal value (Im 3 ph& fine 7)
(8)
1 hereby certify the above is true, correct and
cornplate.
signature of #,a;aesmor
Date sighed
veff"V action- Spgnslure & Xguor
balm, signed
6mvirm Au:owmm
20—P By 20
Lesser of 12 Hoinestead
F.
Valuation or $M.ODO
$
splature of h4w
lDale signed