Homestead_Sutton (4) STATE FORM 53569(8215-09) TREASURER FORM TS-IA)
APPRO;'ED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.I-22-5.
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
ilauses higher tax bills for all; therefore, HEA 1344-2099 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.
PA' l: PROPE' 1' IN ORMATION e.
Taxpayer Name Property Address State Parcel Number Leeal Description:
316 S Hart
Susan M Sutton X 26-12-07-302-001.377-028 019-01377-00 SOUTHWARK ADD
Princeton IN 47670 15 PT
Complete and return to:
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2:TAXPAYER INFORMATION..
Owner I First Middle Last
s'11ar1 �� I Sub4t�
Mailing Address(nunter and street.city state and ZIP code) I Same as property address
�)Q
se First made Last
•
Mains Address(hunter and street.city.state and ZIP code) Same as property address
Social Seauity Hunter(Ian 5 digits) Drivers License State ID Number(last 5 digits) sax Other(pease 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 INFORMATION
•
..• . CLAIM FOR HOMESTEAD PROPERTY TAX
d��` 4.
.�-�':, CREDIT/STANDARD DEDUCTION �
,`+��' State Form 5473 (R2/1-90)
'°�• WSTRUCTIONS: See reverse side lor liling instructions.
I (We)
CERTIFICATION
cupi�d as our principa�
FORM YEAR
HC10 �%��
Su�"o
on the 1 st day of March , 19 �
real property for which a Homestead
❑ Are buying under contract
� Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
property or is buying it under a contract. �� L'
PROPERTY DESCRIPTION
Taxing Distry�
Legal Description
If any portion of the residential struciure or the land not exceeding one (t ) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County �, Township �_ County Township
nereby certify the above statemenis are true. correci and �gn ure
complete.
Address (Streei. number. city, state and ZIP code)
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENT7AL
VALUE
Land not ezceeding t(one) acre immediately
surrounding residential improvemenis (�)
Otherland (2)
Total land - line (1) plus line (2) (3)
Resideniial improvemen[s Dwelling (4)
Garage (5)
Oiher improvemenis (6)
Total improvements - line (4) ihrough line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is true, Signature ot Assesor Date Signed
correct and complete
Verifying Action - Signature of Auditor Date Signed
1989 Pay 7 990
Lesser of 1/2 Homestead
Valuation or $2,500
�—
Signature of Auditor %1
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991 7 991 Pay 1992 7 9— Pay 19 —
Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or �2,000 Valuation or �7,500 Valuation or �1,500
�