Homestead_Nixon (6) STATE FORM 53569(R315-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE ICE-I.I 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
siauses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
pdard 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.
I PARTI: PROPER 1'INFORI%1A ION
Taxwser Name Property Address State Parcel Number Leta'Description:
Gregoryl Nixon 609 R'EMERSON ST 26-12-07-103-003.723-028 DEVINS ENLG 8 PT
PRINCETON IN 47670
Complete and return to: I®hIODIDVO]O1O]m6DIflfOIQDDIJDDDD]®m®
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
. PART 2:TAXPAYER INFORMATION
Owner I First Middle ///A-0,1
Last
6r gO I% Iced
Maiirig Address(number d greet.city,state and ZIP code) Same as property address
609
Middle Lag
fr1Af.21-L? - J0 ifi rl9it)
Mailing Address(number and sreet,ply,state and ZIP code) Same as property address
6,0q 10. emer,50 4 foci,ic�rr, _,v -176 70 J
-
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 I Signature Date
&
\,. : /1 • -• PART 4:ADDITIONAL INFORMATION . -.
i
4
�t^„�Q
a�''" , CLAIM FOR HOMESTEAD PROPERTY TAX
. CREDIT/STANDARD DEDUCTION
+. ��� State Form Sa73 (R2 / 5-92)
�si.
INSTRUCTIONS: See ieverse side lor liling instructions.
.. � � . � econFiren
FORM
HC10
�� '
YEAR
` ��"^!e �JLS�A _ J_ certif tha on t t st da of March, 19_
1 _ Y j�����,��
�� �:) occupied as our pn cipal pl ., . residence the tollowing described real property for which a H � A{pqr D rt�(['�'i,Ff�i'is hereby claimed:
❑ I(We) owned ❑ Are buying under coniract , '�K v
❑ Have a beneficial interest in the entity ihat is liable for the property taxes on the property and that owns ihe property or is buying under a contracL �
• � - CONTRACT RECORDED - �
It buyirg om m�tract, Fee Simple owner's name � . _ .
Recortlers oHice where contract is recorded Record number Page
PROPERTY DESCRIPTION �
County Townstup � Tanirg disVict (city, fown, township)
Parcel nu ber Legal descnption -
o� - 93 � o� cJ'
If any ponion of the residential simcwre or Ne landnot exceedirg one (7) acre that immediately surrounds that s ture is used ro produce income, describe the use and ponion
ot the properry utilized to produce income.
ASSESSOR USE ONLY TRUE TAX . ASSESSED HOMESTEAD NON-RESIDENTIAL�
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately -
surrounding residential improvements. (� �
Otherland (p)
Total land Qine 1 plus line 2� (3)
Dwelling (4)
Residemial improvements - .
Garage (5)
Other improvemenis (6)
Total improvements (line 4 through lina � (7)
Total value (line 3 p6s line � (g) .
I hereby tertity ihe above i5 Uue, correCt, and Signature of Assesmr Date signed
complete_
�ing action - Signa;ure of Auditor Date signed
19_Pay79_
Lesser of tl2 Homestead
Valuation or 52.000
01
STANDARD
S