Homestead_Miller (13) e STATE FORM 53540(N/I-Its) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,20 PRESCRIBED BY ME DFPART4FST OF LOCAL GOVTRSMENT FDIANCE IC 6-1.I222.I
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 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 Deparnnent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Location Address•
_ - Miller, Travis W
1107 S Hart
Princeton IN 47670
1198
Travis W Miller II_I 11110111:1111111011100111010 III 11111111111110111111111011111_ID1I 11111
1107 S Hart St
PRINCETON IN 47670-2339
I'I"rFI.rII"IIIIIIIIIIIIIII'IIFIIIIIIIrIllllll'IIIII'IIIIIIIIII State Parcel Number • Legal Description
26-12-18-101-001.370-028/L E WOODS 32 PT NW
18-2-10.15 AC
• FILED
APR 28 2011 •
This form Mtilititbemeturnechto County Auditor's office. •
Please do NOT send this form back with your tax payment to the county treasurer.
• PART 2: TAXPAYER INFORMATION
•
I First Middle - - Last
/ Uo Li Al rr
Mailing Address(number e and street,city,state,and ZIP code) 'Same as property address
1/07 c: CA S 1"C:nreton 1.J L/71970
Spouse First - Middle Last
_El iing'Aderers(Nw:.ber—nnd
c snet city estate,and Zii'.Ccvdc). - - _ - _ - - - - f'Sa ie"as property wldrss - - -_ - '—
0
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 I I I I Stat
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 •- he ma,b, liable for back taxes and substantial financial penalties.
Owner I Signs.• Date
•
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
- Smte Fam u7a (R6 �+-03)
PreaaiDeE M Me Deperhrront d Locel GoVmmmnrt Finaxe
INSTRUCTiONS: See rerpso a4b b fmp 'sabuc8'onc
G FORM YEAR
�� �'��. "��
I(We) ���L(�/�%(/�- {� r�� certify�tl�al on tF1e°fsiday of March, 20
/�-r6•;�' /I'
I(We) occupied as our principal place of residence ihe following described real property tor which a Homestead Property Tac Cred��lis.hereby daimed:
❑ I(We) owned ❑!ve buying under contract G�BSON COUN7Y AUDI i�^
'' Have a benefidal interest in the entiry Mat is liable (or ihe property taxes on the property and that owns the property or is buying under a conUaU.
If byv�g an conVacl, Fee Simple ownets name
whera mntraU is recoMed
County
Tavnship
district (dry, town, township)
Record number � Page
S,/ ` L�-613 � D-� I Legal de 'pion� � 3 a Is ihe P� ❑NRea property ❑ MoMle Homo (I.C. 61J-�
C�
N any ponion of tha resitlential sW dura or Me land nW exceeding ona (7 ) ace Ihat immedatey wrtounds that swGUra is usetl b praduce income, desvibe the use and portbn
of Ihe pro ulii¢ed to produce i�ome.
��� �
County
Tavnship
I hereby certify the above statements are We, corted and complete.
(num6er aM streef, dry, stafe, ZIP code)
v31 s �L ^�'4'�'�•����2`Ftith�'`�f_ '� '" . u � w...�,g _ � e,� - `i - ,t�' ss '.
�: £5� TRUETAX�"� x �ASSESSED�VM.UE =HOMESTE.4D NON RESIDENTIAL
� �-�' . .t�a .AS4ESS�OR�UE'���.LY_�' �� .�h£[,�.- � �VALUEi�'v�t.,,� sATy00Ya.OPySlTV.35 �'�VALUE�`,�y�c- ��.. ��' VALUE�':.��Y���
?:6:' .fL: v.._.._..,e....,w,.� r%°
Land not exceeding 1(one) acre immediately �'� -�;� �w %� �-� y;�r;ti; �
surrounding residential improvements. ��) ��; ��rM;�'s?������.� :.,.
Other land
K„w a<- � -
(2) �{ "�
, -.7�� �
Tdal land (line 7 plus line 2) (3�
.✓f `''' a§.�,.'� 'a�'+r '�
Dwelling (4) � ;����� i��y� �
Residential Improvemenffi w MnuaOy
Asaeaead MobOe / Alanufac4tred Hame ��9e (5) `4�l�' 1� � ��`��"^ �
�,�:-�w_ ��'��.�.�:�",�`�
a-,� ��.,���;
Other improvements (6) '��"' ='}s '� �
- ��..o _�� ��-�,
TUaI improvements (line 4 fhrough line 6) (�)
Tctal value (line 3 plrs line n (g) .
I hereby certify Ihe above is We, corred, and Signamre ofnssessor Date signed �
complete.
Vrrilyirg aGbn - Signature of Auditor Date sgned
,.`� a.�",�S�a=�,--..�,'�,:::�zs��m'�t��.-��;�'�4.��,.•,`STANDARD;DEDUCTION'AL'COWANCE�.-��''a3,"�`.:C�`.�,'��'�;`,',`:i�r.a,-f�'�r`.:`"�+.��,ss�``_�b—_�"�-�--
- 20 _ Pay 20 _
Lesser of tr1 Homestead S
Veluenon or 535.000
SignaWre ofAuditor " Date signetl