HomeMy WebLinkAboutHomestead_Sullivan (6) STATE FORM 53569(R1/s-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF I neat COVER.\ME t S,NA.NC_IC6-1.1-22-8.1
IMPORTANTINOTICE 0 HOMESTEAD"PROPERTYOWNERS ,,i-
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
*awes 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.
:7;•,PARTITPROPERTYINFORMATION T
Taanarer Name Property Address State Parcel Number Legal Description;
Ronald D Sullivan 717 E BRUMFIELD ST 26-12-07-204-000.562-028 NS LOT 1 PT R3
PRINCETON IN 47670
Complete and return to: Ell[11111111M101111111 II Man n n mono
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
ii'• s ,. a f .. —1'717 • t 4 •t v:l,`' s':'
Owner 1 Fit Middle Last
psi na\d D 4rw z n Slit Veta1-
Mativq Address(number and street,city,state and ZIP code)
L>ci Same as property address
Jpaasa First Middle Last
Stec
`CfYin Ann \�ccE(ivt�Yl
Mailing Address(master arc street,city,state and ZIP code) Same as property address
•
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
FILED
FEB•
�� 7 2013
]
binbON COUNTY AUDITOR
e��'°� ; CLAIM FOR HOMESTEAD PROPERTY TAX
a��'= CREDIT/STANDARD DEDUCTION ,
.�` � State Porm 5473 (R2 / 5�92)
:a• .
INSTRUCTIONS: See reverse side lor filing instructions.
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�i� e) � _ v o �.cia[.� �-./ ' certify that on ihe 1 st day of March, 19_
:) occupied as our principal place of residence the following described real property for wRich a Homestead Property Tau Credit is hereby Gaimed:
Ne) owned ❑ Are buying under coniract - .
❑ Have a beneficial interest in the entity ihat is liable for the property t�es on ihe propeny and ihat owns the property or is buying under a contraci.
� � -CONTRACTRECORDED � �� �� . -
If buying on contract, Fee Simple owner's name . �
Recorders oHice where contraci is recorded Record number Page
County '
Parcel number
� � q-oo 5L
If any portion of the resid
ot the pmperty utitizetl to
- . PROPERTY DESCRIPTION
Township Tarir�q �triti (Gry. fown, town5hrp)
Legal descnption
swcwre or Ne land not exceetling one �t) acre t�at immediately surmuntls tha� sWCture is used ro produce income, describe Ihe use and portion
ice inmme.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Couniy Township Counry TovmShip
�eby certiy the above statements are true, correct and complete. Signa2ur ot aaimam '
Adtlress (number an0 street, ciry, state, ZIP code)
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL �
VALUE VALUE. VALUE VALUE
Land not exceeding t �one) acre immediately
surroundingrASidentialimprovements. (�) ��
Otherland (p) - �
7otal land (line 1 plus line 2� (3)
Dwelling (4) � � ' .
Residential improvements .
Garage (5)
Other improvements (6) .
Total improvements Qine 4 th�ough line � (7) �
Tolal value (line 3 pLs line � (g)
I hereby Certity ihe above i5 irue. CorreCL and SgnaNre of Assessor Dare signetl
complete.
�irg action - Signature ol Audiror Date signed
19_Pay19_
Lesser of 1l2 Homestead
Valuation or S2.000
�
DEDUCTION ALLOWANCE
5
si9ned