HomeMy WebLinkAboutHomestead_Moore (7) STATE FORM 5P69(R3/8-10) TREASURER FORM TS-IA
APY.(OVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.I--22-8.1
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 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.
s j>- 1 t M .-:'y,' a , .,-;PARTI PROPERTY INFORMATION t , u 419 :,.;„lit.t,s'ri• • ,
Taapaser Name Properts Address State Parcel Number Leal Description:
Eric R Moore 1405 S JEFFERSON AVE 26-12-18-103-003.481-028 BALDWIN HGTS I BLK 5
PRINCETON IN 47670
Complete and return to: I®IIUl]I]VO IIIIHRIIMMII I D11d1IIli[I11IlIIII
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
1 "34414 -
:' PART 2:.TAXPAYER INFORMATION '= .g.ga • - - .
Owner 1 First Middle Last
Eric gy aIn Moore
Matting Address(number and street,city,state and ZIP code) I
' ame as property address
Spouse First \ an 0 Middle Last
1�Q.nGe — /l 1�Y1oot"¢
Mailing Address(number and street,city,state and ZIP code)
I Same as property address
ti 'ITP:. 'i; :P-i .k.i !'.v,_ .-t 7.:or:.t„•
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 Signature - Date
i
s
a+' ""!
4�� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
` �• SUte Fwm 5473 (RS / 10-01�
� Prestribed by the Depariment of Local GovemmeN Finance
INSTRUCTIONS: See ieverse side Jor filing inst/uctions.
_ � _ ' . � . _. . - ; .:n - . - - _ CERTIFICAT
FORM
HC10
YEAR i
I(We) r�,�,((��TQ � � �/ 1�,J(J �.iL. certify that on the 1st day oC( Ma'rnch(�, 20
I(We) occupied as our principal plac f residence Ihe following descnbed real property for which a Homestead Property T� 6r�dit1isJae�oy�aimed:
❑ I(We) owned ❑ Are bu ng under wnlract /
�Have a benefidal interest in ihe entity that is liable for the property taxes on the properry and that owns the proq�y or is bupr� un�a con�ast.,
��c{i'.�"=''_...t.�s.x>r�' -�c...'�'`�` ..",-_=' . z 1.:�.5.;-p...CONTRACT'RECORDED`... . c�.._.�.� ..:y..-,v� .. ic:-b. ....��-.__ � .
If buying on contrad. Fee Simple owner's name
Recorde(s olfice where wnlract is rerqrded Rewrd number Pa9e
Counry
_'-t-�,-'-_
..: Tavnship �'
U � l� V tJ-1 U('F%� ��VLC�f� �
If any ponion ot tha residential sWCWre w Ne Wnd not exceeding one (7)
ot the propetly utilizeE m produce income.
ESCRIP.TION'� -` T�'.� "�-� .°"". . ". ^�' � .
Taing dis�rit� (tiry, tawn, fownship)
Y I ( Is ihe pmperty in question:
❑ Real pmperty ❑ 6lobile Homo Q.C. 61.1-7)
immetlialely surrounds tha� sWUUre is used lo produte income, tlescsibe Ne use antl portion
'-`C- m:.,.:� �„� --. r ' _ .,r_.y:�'.:.�.
.':; z-'-'�"`�'PROPERTYOWNEDBYCLAIMANTINOTHER'COUNTIES ':;i� -..?'t..,.
County Twvnship County TO.vnship
I hereby certify lhe above statements are W e, correct and complete. Si atur ( claimant
�ress numberand . l, c� , tafe, ZlPcode)
��`��� �'��` ASSESSOR USE ONLY �� i x�� '- TRUE�TAX � ASSESSED VALUE HOMESTEAD „� ��1� -f NON-RESIDENTIAL �r ��
i-.._i:�°.�3�''.�'�.-ti'�r .�H';c.u�'-� : rx _:�++� VALUE_ 'AT100%OF.�TN .'VALUEq`'T �7 c.VALUE..+.:��!i?.:�'
Land not exceeding 1(one) acre immediately <� �` � r,h �a `T'
surrounding residential improvements. (� � .. t.. -.,��c.� �;-� •. �; ;'�, .,,-°�r � -
� rr. `
Other land (Z) -. � �{sr ° i'
. �'s:: ,..t:..� _:�_� .
Tdal land (line 1 plus line 2) �3)
. +�_ za �a ,R r �;
Dwelling (4) f b: r}tr',�� � s��.5a�i �c6
ResidenGal improvemenLs ,i� + � -,�.�,. � s.-..,,
9 5 .. r ��'c� �v�:�# �'�y=:
Gara e (� y t}� fSf-JZ"-.,. �'�'�.��x' ,{'•,-�•�
u T -i� �� .'f
Other improvements (6) 4�, F; �,sz..., .,_'
Total improvements (line 4 fhrough line 6) (7)
Taal value (line 3 plus line n (g�
I hereby certiy ihe above is Uve, conect, and Signature of Asseswr Date signed
complete.
Verifying actbn - Signature oflwditor Date signed
20_Pay20_
Lesser of 1@ Homestead
Valuation or 56,000
Signawre otlwditor
5