HomeMy WebLinkAboutHomestead_Burch •
., STATE FORM 53569(U/610) - raEASCRFII FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.HW PRESCFIBFD BY TIM OEPARTMER OF LOCAL GOVERNMENT FINANCE IC 6-1.1-214.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
° 101 N.Main Street - Individuals and married couples am limited to one homestead standard deduction. As the receipt of this deduction becomes
Princeton,IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
's - -HFA-1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to receive the
® yg efit and to provide additional identifying information necessary-to allow county government to better monitor homestead
p - ' .II gs-This information will be kept confidential and can only be accessed by authorized county-officials.The Department of
J6i`!, - .I Government Finance will use this information.to create tools that will help county officials eliminate homestead.fraud.
.. - PART I: PROPERTY INFORMATION
APR 15 2011 . Taxpayer Name , Location Address
C.3. . , . •c" Burch, Thomas P/Marion A
-
625SSR 57
GIBSON COUNTY AUDITOR OAKLAND CITY IN 47660
5061 .
Marian ABurch WIh i1. 1110[011111[ii I00I1010111010Th1 111111101101101IL011011l[I]II l
625SSR 57
OAKLAND CITY IN 47660 •
• State Parcel Number Legal Description
26-14-18-101-000.116-006 /FARMER&SON TRACT 2 C-1
-S
1 ` This°form MUST be returned to County Auditor's office. -
Please do NOT send this form back with your tax payment to the county treasurer.
1r t_-.. PART 2_TAXPAYER 1\FORNIaTION ,_ _
Ow.. . t - First - - Middle - Last
Mailing Address street,city.state,and ZIP code _ 'Same as property -
C7Qb Sk .i' 7 . , ,
L Spouse - Firstl - Middle Last
•
Mailing Address(Number and street,city,state,and ZIP code) fl Same as property address
Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
1 1 1 1 I I I 1 I am,e
` Each undersigned certifies,under penalty of perjury;that the above andforegoing'infotrnation 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 aannd substantial financial penalties. - \/- . �y7//�
N np
a CLAIM FOR HOMESTEAD PROPERTY TAX
a CREDIT /STANDARD DEDUCTION
State Form 5473 (R215 -92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
I (We) .V1� Ld:a f �(�i10� f C / �0�/� /7 cert i•-7t t 1st a�o .. is19_
r t' "re) pied as our principal place of residence the following described real property for which a Homestea i+L redit is hereby daimed:
. (We) owned ❑ Are buying under contract �y11((��jj 0110%
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the prowor its buy�ng undera co lr act.
CONTRACT RECORDED, . - w �::�I:`•,: r~'""' -
It buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
- PROPERTY DESCRIPTION
County
n
Township
Taxing ct ("
l
town. township
70.
Par eI num er
Legal descd n
VALUE
y
00 ) V /
Land not exceeding 1 (one) acre immediately
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that
structure is used to produce income, describe the use and portion
of the property utilized to produce income.
surrounding residential improvements.
- . //G -406
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
,reby certify the above statements are true, correct and complete.
Signature of claimant
Address (number and street, city. state. ZIP code)
TRUE TAX
ASSESSED
HOMESTEAD
NON•RESIDENTILAV
-'°
ASSESSOR USE ONLY
VALUE
VALUE
VALUE
VALUE.
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
111
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pbs line 7)
(8)
I hereby certify the above is true. correct, and
Signature of Assessor
Date signed
complete.
action - Signature of Auditor Date signed
®verifying
STANDARD DEDUCTION ALLOWANCE"' .
19_Pay 19_
Lesser of 112 Homestead
$
Valuation or $2,000
Sign of Autlit
Date signed