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Homestead_Salt STATE FORM 53569(R315-10) TREASURER FORM TS-IA APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1-"-5.1 IMPORTANT NOTICE TO I-[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 - auses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead a dard 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. PA' I: PROPERTY N- FORMATION.-, Lzpaver Name Property Address State Parcel Number Leal Description: Mitchell Salt 607 E EMERSON ST 26-12-07-204-000.051-028 NS LOT l PT R2 PRINCETON IN 47670 Complete and return to: EIMIBIIEDIMEmmmmEEK11mhh®0® . GIBSON COUNTY AUDITOR,101 N MAIN PRINCETON IN 47670 - - — '.PART 2:TAXPAYER INFORMATION °.1" - Owner 1 First Middle Last ly)i �E// Cp wl Ei2OAi 5i9-L-T Mailing Addr (number and street,city,state and ZIP code) Same as property address 667 E. 041enSoRA" (PQJn'cc-r04i -Ti'.,. 76-7 0 First Middle Last t7EAfv 71/fiKi.,C- • SACr Mating Address(nunber and street.city,sate and ZIP cede) Sane as property address - (�o7 6: 14. --4/6--71--SCW Pet- ivCeTO' ' ..4—P.d . 11-1 (37 0 _ 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 4, .. ` PART 4: ADDITIONAL:INFORMATION 'le . ' •• ' - FILED . 40 NOV 14 2012 umSON COUNTY,UDITna CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION ` � ` State Fum 5473 (RB / 7-07) PresCn�bed by �he Depar4nerrt of Loml Govemment Finance INS7RUCTIONS: See reverse side /or filirn� ins6uctions. � I � � HCRO YEAR �/ DEC 1 1 2008 ��e� � � � �% ��at on the 1 st day of March, 20_ I(We) oxupied as our prindpal place oi res' ence tlie bwuig described real pr� a omestead Property Tac Gedi[ is hereby daimed: �(We) owned ❑ fve buying under mntraIX Have a beneficial interest in fhe entity that is liable for the property taxes on the property and that owns the property or is buying under a contract. 11 Wyu�g on oontrecL Fee Simpe awnefs rmme Recortle/s otfica wM1are wnUad is recartled Caunry TamsAip Parcd number Recadnumber �Pape Tanng di6Uict (cify, to•.m. fownshiD) a�-�a-�7-a��-uxi, d�5/-Oa Is ihe M arry portmn of tlre residerNal sVUdure w Ihe land nol erzceeding orre (1) acre Ihat immetlialely wnouni aFlhe WuPertY WGzed tn produce inooma. a�-� a -�� -a�v-�o. os�-� a� pro m quesUOn: �property ❑ Mobile Fbme (IC 6-1.1-n ihat sVUCture is used to pioduce inwme. desvibe the use aM pwtbn ,_ , , . .. . . ., . � land not exceedirg 1 (orre) aae immediatey � • - '. . - � � surtoundingresidentialimprovemenfs. ��) �� - � � Ottier Wnd (Z� - :.. .. Tdal land (1'me 1 plus 1'me 2) (3) Dwetling (4) .�:� c•j � �...°a. � - ResidentialimprovemenLsaMnually ,,e�_m,���-.� __ Assessed Mobile / ManufaGured Home '.l� , �� ` � . � Ga2ge �5� .�:: .., .SY�°`i,, - •.';z�:'i.. _ Other unprovements (g) � . M1,::� `:''ee. .... 7da1 improvements (iine 4 through line 6) �7� Tcfal value (line 3 plis lirre � �g� I hereby certify the above is We. cwrett. and signawre otPSSessor Date signed (monN, aay, yea� complete. vaityinp aaon - sp�wre a nuanw Date signed (monih, day. yea� �KLC2 PaY ���L/ 4S,ppp for 2007 pay 2008 42.000 for 2010 pay 2011 Lesser of 12 qq.ppp for 2008 Homestead Valuation PeY 2009 41.000 for 2071 pay 2012 $ � 43,000 for 2009 pay 2010 40,000 payable after 2012