Homestead_Minnis (7) STATE FORM 53569(R3B-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,3009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE 106-1.1-22-11 I
flit 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 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.
PARTI; PROPERTY INFORMATION_
Taspaver Name Property Addresg Slate Parcel Number Lent Description:
Stephen B Minnis 933 S STOUT ST 26-12-18-202-001.597-028 SS ADD 368
PRINCETON IN 47670
Complete Will return to: 1111111 [1JI[UHIIIllOIDDIII➢lhlllllDF II IIEIIFIDEI IIII
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
z . r PART 2:TAXPAYER INFORMATIONt!' ' i -^.
Owner 1 First Middle Last
S$eehe_ n Br0.JLey /1 I A is
Mailing Address(number and street,oty.state and ZIP code)
1/ Same as property address
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 :-gnature Date
5w«:PARTa ADDITIONALANFORMATION t, ':=t4
FILED
• NOV 5 2012
GIBSON COUNTY AUDITOR
. �. ti�
t CLAIM FOR HOMESTEAD PROPERTY TAX
� - � CREDIT/STANDARD DEDUCTION
t � Slata Form 5473 (RS / 16-01 j /
���� Presaibed by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side lor (ling ins(ructions.
:� ��
� � ' ������
I � 3 F�f
Ie / ' _._-.. ' _
(�'v ) cer6fy that on the 1sl day-o ar 0
'i �.�� ,.i-.i
I(VJe) occupied as our rincipal place of residence the following descnbed real property (o'r which a Homestead Properfy �ac�G�ed�t i� r�by �Bii
❑ I(VJe) owned ❑ Are buying under contract
�iave a benefidal interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a wnVaG.
If buying on conUad, Fee Simple ownefs nama
where conuacl is recorded
Township
townshiP)
Record number � Page
Parcel number / —/y� Legal description r Is the property in question:
hL� �0 ( � �, �CJ �S �� 3l� � � Real propeRy ❑ Mobile HOmo (LC. 67.7-7)
tl any portion oF Ihe resiAential sWClure w Ne land not exceetling ona (7) aae lhat immetliatety sunounds that swcture is used to produce income, desuibe the use antl portion
of Ihe properry utilized to produce income.
��'�����'�'s"'''�'K`��`�`"`�-"3 �g �"sTRUETAX+�� �ASSESSED�VALUE �'HOMESTEAD'�""� �yNON�RESIDENTIAL�
?.�^-�-.a.. A.�SS_ES50 �SE�O�NLY����._� ��VAI:UE �-�; . "AT�100°/a_OF�TfV T-VALUE t -�J'��VALUE ��,
� ��._ F:t .m .� ,u �C�L1a..-.,- �.� � �T�
Land not exceeding 1(one) acre immediately � �?���;;��° �_�'^��,°�', �
surrounding residential improvements. � � �>w� s�-�v''� :���i
F JIY� 3A`"sZ• 4q'��:
Otherland �p) � �' ''��.
t ��,�
Total land (line 1 plus line 2) (3�
.� s��*>-+���a�:x y�.� ���
Dwelling (4) �s�fi`n-����� ��-��
Residentialimprovements f_,..._. 1 _,.���
Gara e ��'1 �[j,' - 'S�
9 �5) � "'' 4 G us � e::. �S �
3_ �,$
Other improvements (6) 4'`� r,��
� �?"�:i°i..�'' - :�s`"r
Total improvements (Irne 4 through line 6) ���
7dal value (line 3 plra line n (g)
I hereby certi(y fhe above is W e, correU, and Signamre o(PSSessor Date signed
complete.
Verifying action - SignaWre ofAUtlitor Date signetl
20_Pay20_
Lesser of 7!2 Homestead
Valuation or $6,000
3
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