HomeMy WebLinkAboutHomestead_Smith (41) STATE FORM 53569(R3/3-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE 106-1.1.22-B.1
p° 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.
ktc �'°1rt :-• -PARTI: PROPERTY INFORMATION I .. v. .;t
Taspacer Name Property Address State Parcel Number Legal Description:
Stephen NI Smith 125 S WASHINGTON ST 26-12-08-301-003.358-028 HIGHLAND HOME 11 PT/I2 PT/13
PRINCETON IN 47670 PT
Complete and return to: Im1 Ill I, 11110!1(11�0 011111 ff�lg911:11[11&OIIPI131rIDPIB III
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GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
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Owner 1 ff�
Lev, I� Middle Last
J-rCQ Lev, I/s s t C cu e I 5r71 1
Mating Address(number and street,city,state and ZIP code) ✓)same as property address
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mwuse First Middle Last
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Mailing Address(number and street.city,state and ZIP code) n 1 Same as property address
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4_2::: PART 3:.CERTIFICATION'?. * E : tt : : l ! : ._
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
:
FIT , PD
JAN
aG11 2013
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GIBSON COUNTY AUDITOR
��'�"" - CLAIM FOR HOMESTEAD PROPERTY TAX
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` CREDIT/STANDARD DEDUCTION
� State Form 5473 (R2 / 692)
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FORM YEAR
HC10
INSTRUCTIONS: See reverse side for liling instrvctions. �
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' � CERTIFICATION STATEMENT
1(VJe) � _ '� • certify that on the 1 s�[ cd1fa1KoF Mamh, 19_
1(We) occupied as r principal place of residence the following described real property for which a Homestead Pr�e� T�rq,p�utl hereby claimed:
❑ I(We) owned ❑ Are buying under contract ;• � %� ;� I�
❑ Have a beneficial interest in the entiry that is liable for the propeRy taxes on the propeAy and thai owns the property-w�is buyiP9;�Sder�atentract.
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%tI� ,ir:56i4 �:�:'.:�i'i A.UDIT(?
CONTHACTRECORDED �
If buying on conVact, Fee Sunple owners name .
Recorders office where rnntract is recortled Recortl number Paqe
PROPERTY DESCRIPTI
nry � Towns Tazing di � iry, Yown, towns )
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Parcel mber Legaldescrip6on
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If any poNOn ol ihe residential sirucWre or the land not exceeding one (1) acre that immetliatery surtountls ihat stmcture is used to produce income, describe the use and portion of
Ne Droperty utilizetl to protluce incame.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Caunry Township
Sg tu of c imam
�reby certity the above statements are We, correct and complete. � '
Address (num6er antl street, ary, sfate. ZIP o4de) , '
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ASSESSOR USE ONLY TRUE TAX ASSESSED OMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately (� �
surrounding residential improvements �
Otherland (2)
Total land (line 1 plus line 2) (3)
Dwelling (4)
Residential improvements
Garage (5)
Oiher improvemenis (6) "
Total improvements (line 4 through line 6) (7) �
Total va�ue (line 3 plus line 7) . (8)
I hereby certify the above is true, correct, and Signacure of Assesar Date signed
wmplete.
Verifying ac6on - Siqnature of Auditor Date signetl
STANDARD DEDUCTION ALLOWANCE
' 19_ Pay79_ .
r of 1/2 Homestead S
V uation or 5 0
Signature ol Auditor Date siqneAd
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