HomeMy WebLinkAboutHomestead_Mills STATE FORM 53569(113/5-TO) TREASURER FORM TS-IA
APPgOVED BY!TATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.I--22-5.t
-7=7 7. IMPORTANT NOTICE TOJIIOMESTEAD- 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
uses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
Sm idard 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.
` PARI f'PROPERTI INFORMATION : 'I
Taxpayer Name Propert Address State Parcel Number Leta)Description: /'
Kimberlie S Mills 524 S SEMINARY ST 26-12-07-403-000.057-028 SUMMERS ADD 5
PRINCETON IN 47670 tII1tP1
Complete and return to: I®IID�DfH]ifim11nUiE;pm11011J:I d9I IIIuoIq
GIBSON COUNTY AUDITOR. 101 N MAIN PRINCETON IN 47670 W�
4.r.=-.;S si .,. _ ,.,c '= .. I ., ,Al ART 2.,FAXPAYER-INFORA'IATION `
Owner I First Middle - - �
Last
11herlie due 1\k; IS
Mailing Address(nunter and street.city.state and ZIP code)
Same as property address
5-S2q T>la;ne CW( Rr‘nceon tl,.s 4
First Middle . Last
Mailing Address(number and street.city,state and ZIP code) Same as property address
Soda/Scatty Hunter(last 5 digits) Duvet's License/State ID Number(last 5 digits) stae Other(please spedly in Part 4 below)
r ` ` 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 Sgna re Date
'• . . .. PART 4: ADDITIONAL,INFOR■ ATION - .
ill 4.
2 CLAIM FOR HOMESTEAD PROPERTY TAX FORM
YEAR
CREDIT/STANDARD DEDUCTION HCto
State Fwm 5473 (RB / 1-03)
Prescribed by the Department ot Local Govemment Rnance
INSTRUCTIONS: See revcrse side lorliling insl�ucfians. �
$iy_. �. . _. .
��.�.�r�r?��-�e+�-'���'_��"�*V�'�.'3—'�"c�CERTIFICATION����_STAiEMENTFe't��a4K� �i�q , �'; � `� �1"%...z.�.}i� .��.`C,,"„';;:
I(We) ' , certify @�t�n t�ie�s��f March, 20_
I(We upi d as our principal place of res dence the (ollowing described real property for which a Homestead Property Tac Credit is hereby daimed:
I(We) owned ❑ Aie buying under contracf � � �j � (%
Have a benefidal interest in the entity ihat is liable (or the property taxes on the property and Nat
If Cuying on conVad, Fee Simple ownefs name
Remrdefs ofice whera contrdct is recorded
County � Toxnship
Rewrd number � Page
the O��rtY in question:
property ❑ �bile Homo (I.C.
It any portion of Ne resiCentlal sW dure w Me land na exceeding one (1 � aae lhet immediatety wnounds that swcture is used to produce income, describe the use and portbn
of ihe properry uWized tn produce income.