Homestead_Beauchamp (2) t :MIL FORM limo IR !API NI mRFAnlln<FORM TS-IA
APPROVED DT Cr xn.BOARD OEM"v R'NI x.air/ PRrrrBIDIDDY PIE DEPARPANT(w LOCAL CAYEFNMEN'r FINANCE IC 4-I.1-2:-$.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead andanl deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ner for homestead fraud.homestead(mud causes higher tax bills for all:therefore.
® HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor holtmtead
filings.This information will he kepi confidential and on only be accessed by authorized county officials.The Dqunnlent of
Local Government Finance'ill u.c this information to create tools that will help county officials eliminate homestead nand.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Beauchamp,William J/Mary J
WI Box • y
Oakland City IN 47660
`
5621
William J/Mary J Beauchamp
R2 Box 72 A State Parcel Number Legal Description
Oakland City IN 47660-8124
26-14-19-400-000.043-006 003-00043-00 PT SW SE 19 2 8 18.51 AC
I II I I Is II ru I I I I ear I a I un I I uIrtI u l II Il II rl I I
C-1
X.
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
ti Address(number and street.city,state,and ZIP code) -- - —-—fl-name as propety oadress - - - - "-- - - — --
Spouse Middle Last
,oaf J0 e aPn1
Mailing Address(Num r and street,city,state,and ZIP code) ❑ Same as property address
/3/742. 0/51261 &I (Oa &r ( IKtf710(o6
PART 3:CERTIFICATION
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/Sign/true 7 / Date
r
CLAIM FOR HOMESTEAD PROPERTY TAX FORM r YEAR
CREDIT/STANDARD DEDUCTION
State Form 5473 (R5110 -01)
Prescribed by the Department of Local Government Finance
:-CERTIFIQATI0ASTATEMENT%-
JL--d
I (We) U Ic LAI a ify that thUt.WMarch, 20
led real property for which a Ho
I (We) occupied as our principal place dence & following disin' h,,h a Ho Pr4?9 I r ereby claimed*
❑ trill"s 1 �V
I (We) owned ❑ Are buying under contract
ave a beneficial interest in the entity that is liable for the property taxes on the property and that owns a grope ract.
It I It
CONTRACT' RECORDED ' ^: f--
I <:_ _' __ . _
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
$V4-
, 36;PH PROPERTY.
County
Township
Taxing district (city, town, township)
I I
P..I
Le a d scrip'
Is the property in
Pn!�
9
1 B,Ly ^eal property ❑ Mobile Home (M 6-1.1-7)
_-a-
If any portion of the resitlenual sWCWre or the Tend not exceeding one (1) acre that immediately surrounds that structure is used to produce incoune, describe the use and portion
of the property utilized to produce income.
9-,r4 Inc—
Signature of Auditor
L
r' -ix PROP. E RTY.6WN ED BY CLAIMANT IN OTHER-COUNTIES
County
Township
County
Township
I hereby certify the above statements are true, correct and wmplete.
Si ure of cl i nt
ess (number and streal, city, state, ZIP code)
00
TRUE TAX ,,4;-1,j-,--,,�
.'',,.VALUE
ASSESSED
-
HOMESTEAD
-RESIDENTIAL
I
-�i
T F
-A .100%0 TT/
—'--VALL)Efi�.
(iNON
r
Land not exceeding 1 (one) acre immediately
Valuation or $6,000
Signature of Auditor
surrounding residential improvements.
Date sqn
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Pt
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct. and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STANDARDMEDUCTION ALLOWANCE
20 Pay 20
Lesser of 172 Homestead
Valuation or $6,000
Signature of Auditor
L,-)
Date sqn