Homestead_Radigan STATE FORM 53569(RYS 09) TREASURER FORM TS-IAI
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF Loy GOVERNMENT FINANCE IC6-1.1-22-8.I
`IMPORTANT .NOTICE TO H.OMESTEAD 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
4Pauses higher tax bills for all; therefore, HEA 1344-2099 requires taxpayers who receive the homestead
st ndard 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.
a :7n iii wiMMIMI• IN .
Tasoaver Same Properly Address State Parcel Number Leal Description:
Joanne Radigan 605 South Gibson Street 26-12-07-403-003.081-028 019-03081-00 PT SE 7-2-10.08 AC
Princeton 0447670
Complete and return to: \
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2:TAXPAYER INFORNIATlON „ -
time I First Middle Last
{� -
'�DA-M419-11- (-AA/
Mating Address(minter and street.city,state and ZIP code) t/ Same
as prppedy address
6.a5 §0k-/—h CIbson SE,
-
Middle Last
Mating Address(number and street.city•state and ZIP code) Sarre as property address
Social Security Hunter(last 5 digits) Driver's License State ID Number(last 5 digits) sae Other(please specify in Part 4 below)
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
)
PART 4: ADDITIONAL INFOR%IATION
Ill
•
. R. �
a.`' � CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
�'�� CREDIT/STANDARD DEDUCTION H �"jI�_C�, _\,
.`� � � State Porm 5473 (R2 / 5-92) ���
INSTRUCTIONS: See reve�se side lor filing instructions. � .
: n
CERTIFICATION STATEMENT �
��"" e) certity ihat on th4�YSY,t1ap�1�o'NnA1�aTr/cR�.�p{�q p�(�� �
) occu ie as our principal place of r idence the following described real pwperty for which a Homestead Property Tax CredRVBS�rAnyCiaimed:
I(We) owned ❑ Are buying under contract
,—I Have a beneficial interes� in �he en�ity tha� is liable for the property taxes on the properry and Ihat owns the property or is buying under a comract.
CONTRACTRECORDED
L` buying on contran. Fee Simple owner5 name
IRecorder's ottice where contract is recortletl Record number Paqe
PROPERTY
Couniy
Parcel number Legal de on
�119 _cn?�c�R ( ��- �� �-,�-I (1 . 08 R
portion of the resitlential siruaure or �he land not e.ceeding one (11 acre that fmmediateiy surwunds ihat stmcture is used ro produce Income. descrihe ihe use antl portion
pmperty utilized to produte inCOme.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Counry Township Couniy Township
�— �—
�eby certify the above statements are true. correct and complete. S�gn �. o� cia�
Adtlre/ss�hnumbe/antlsVpeeLUty.stafe,ZlPCOtle) �/.(�)' !, �� � b
� l0 V� /1 _ V _
ASSESSOR USE ONLV TflUE TAX ASSESSED HOMESTEAD I NON•RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately I( � I I I
surrounding residential improvemenis.
Otherland (p)
Total land (line t plus line 2� (3) I I
Dwelling (a)
Residential improvements
Garage (g)
rfOther improvemenis (6)
Total improvements (line 4(hiough lina � I(7) I I
7otal value (line 3 p6s line 7� (g) I
I hereby certity �he above is tme. correci. and I Signa;ure of Assessor IDate signed
complete.
`�ying action - Sfgnamre oi Autlrtor I Date signed
STANDARD DEDUCTION ALLOWANCE
I. 79_Pay79_
Lesser of 1/2 Homestead
Valuation or 52.000 S
Signature of Autliwr ('� � Dai� slgned
jj, L - �S