Homestead_Owens (7) STATE FORM 53569(R313-10) TREASURER FORM TS-IA I,
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE ICSt.l"_-SI
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
uses 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.
raT911"PROPFRTI i\FORMATION
+, • ' . ._ .., gym... . -._, . . .,
Taxpayer Name Property Address Slate Parcel Number Leval Description:
James A/Clair J Owens 419 S HART ST 26-12-07-304-002.007-028 HALLS ENLG 4 PT/13PT/14PT
PRINCETON IN 47670 IIII11 m '�W pp
Complete and return to: I®110 Df W tI Omli0I71IIW
W 1 0E11111 11 fi11®®
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON LN 41670
.
q �.e First ( Middle ' Last
/4 1 r ` �f
Mang Address(minter and street.city.state and ZIP code) Same as property address
•
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.
;;PART 4: ADDITIONAL INFORMA 1 ION " „
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FILED
® JAN 3 atemieviat--
GIBSON COUNTY AUDI 1 Uk
r
�ti� -
,�HOMESTEAD PROPERTY TAX
rANDARD DEDUCTION �
(R2/5-92) � . .
'S: See reverse side !or /iling instructions.
�ORM YEAR
H� 0 9�
n �0 5
9 ,� ,
'�"' �•. l/ �Y�� � �Yl�tlJlll+X� OWL/litH-- certify that on ihe 1st day of March, 19_
'>d as residence the tollowin escribed real property for which a Homestead Propeny Tax Credit is hereby claimed:
i
❑ I(We) owned ❑ Are buying under coniract . - .
❑ Have a beneficial interesi in the eniity that is liable for ihe property taxes on the property and that owns the property or is buying under a contraci.
� . - CONTRACT RECORDED . -
If buying on contract, Fee Simple owner's name - , ,
Recortlers oHice where contract is recortled Record number Page
PROPERTY
Counry , . Township . - . Taxing tlrsvlct (ciry, rown,
Parcel number Legal descnption
- - O � �l !�3
If any portion of ihe residential sirucNre or Ne land not exceediry one (7) acre that immedi , ry wrrounds that stru<
of the property utilized to produce income.
� PROPERTY OWNED BY CWMANT IN OTHER COI
Counry Township Counry
�nify the above statements are true,-correct and complete.
--�
Address (numberarMS(ree7. ary, state. ZlPCOde)
ASSESSOR USE ONLY
Land not exceeding 1(one) acre immediately
surrounding resideniial improvements.
Other tand
Totallantl (line 7 plus line 2�
Dwelling
Residential improvemenis
Garage
IOiher improvemenis
Total improvemenis (line 4 thiough line �
Total value (line 3 p�s line 7�
I hereby certify the above is Irue, correci, and
complete.
.��aclion - Signature of Auditor
19_Payt9_
Lesser ot 1/2 Homesiead
Valuation or 52,000
TRUETAX ASSESSED
.VALUE VALUE
l�)
l2)
(3)
(4)
(5)
(6)
l�l
le)
Sgnature ot Assessor
�
produce
HOMESTEAD
VALUE
descnbe ihe use and ponion
NON•RESIDENTIAL
VALUE
Date signetl
Date signed
SignaNre of AWUOr �/� / , n• �, I Date si ned
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