HomeMy WebLinkAboutHomestead_Collins (2) STATE FORM 53569(8115-10) TREASURER FORM TS-IA
• APPROVED BY STATE BOARD OF ACCOUNTS,1009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC61.1 22-8.1
r ,r ,. , %g4 IMPORTANT NOTICE TO HOMESTEAD PROPER�TY`OWNERS `
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Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
`—fuction 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.
., �. 1X
„ :,,,. .• .wu, ...�:r yam, ;.;� .; :PARTL• PROPERT.YyINFORMATION ' '
Tamaver Name Pronem'Address State Pa reel Number Leoal Description:
Michael T Collins 12667 E 150 S 26-14-20-100-001.528-006 PT NW NW 20 2 8 1 AC
OAKLAND CITY IN 47660
Complete and return to: 11111111[111(11110 BEIE11[111111111111E11111M113111111111
GIBSON CpUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
. . rn }-4-4."lit-.!? :`ra PART2 TA''XPAYER.INEORMATION
Ovmer 1 t First -f�_ + Middle Last
m l�-�li l 1 C d c Q �l/�/l�j
Malting Address(number and sweet city,state and ZIP code) erne as property address
•-pause First Middle Last
Mating Address(number and steel,tiry,stale and ZIP code) Same as property address
Soda!Security Number(last 5 digits) Drivers License/State 10 Number(last 5 digits) State Other(please speedy in Pad 4 below)
x;;a,b ,. .L. PART-N'CERTIFICATIO_N >.'.. ;'z^; Cir.`.,
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
...
_ M,�r. .,_ �.,�I'.;PART.I;YADDITIONALINFORMATION .',
•
0
CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
CREDIT /STANDARD DEDUCTION
State Form 5473 (R71 Steal fiu-
Prescribed by the Department at Local Goventirnerd Femhoe
INSTRUC'nONS: See reverse side for Vb7g instructfiens. FEB 1 9 2008
" " ` .' - . ... " , , - - . „< rxa PATVIUR 4r&WSacarr 1V t, 13 , s T, . . r
I (We) C mle_ A mi S" I C4 Can* 6v ;:Y, 20
19) occupied as our principal &6 of re6derice the biltmAng descried real property for which a Homestead WA, WQML.—
I, (We) owned [:1 Are buyng urWar contract
Have a beneficial cial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a corttract.
CONTRACTRECORDED,'`-id-
I bt4T9 on .,b Fee Sin ple owner's name
Revorder's office where contradis recorded Record number Page
:PROPERTY MNE613Y CLAMANT IN OTHER COUNTFES�
PROPERTY DESCRIPTIOW!'
Township
County
County
TawrJvp
Tacing d town, fownstup).
of
Parcel murd"
Legal description Is the propW
. question:
on:
6- CEI 5 x4 CA K71ee
— k 'k - a
) O I . 's- n:g
P Real property
❑ M.61. Home (LC. 6.1. 1-7)
ff any portion of the resKW*W structure or the Land not exce"rig one (1) acre k dud s&Lcbxe
is used to prod" inoxne. describe the use and portion
of the property utilized to prockcs income-
untrounding residential improvements-
:PROPERTY MNE613Y CLAMANT IN OTHER COUNTFES�
County
Township
County
—'NNON4�0
N
Towrhship
I hereby certify the above statements are true, comect and complete.
of
L�'VALUE
(number and 3fn a art: stafe. ZIP oDde)
�3
6- CEI 5 x4 CA K71ee
6 0
USE ONLY 3"
TRUE
—'NNON4�0
N
'A�
kATAOD% OF, TTV'
L�'VALUE
VALME�� "1 °Y
�3
Land not exceeding I (one) acre immedalety
untrounding residential improvements-
611
Other land
(2)
Total land (1k* I plus line 2)
(3)
Dwelling
(4)
WIM
Residential rmprovements or Annually
Garage
i
Assessed Mobile h0lanutactuied Horne
(5)
W
Other onpravements
(6)
Tdal ffnprovements (lone 4 Ovough fine 6)
(7)
7cW value (line 3 john fine 7)
(8)
I hereby certify the above is true, carted, and
complete-
Sombare of ASaessa
I
Data
Men" action - Signabure of Audhx
Data signed
20 Pay 20
Lesser of 112 Homestead
Valuation or $35,000
Sgiature
, I -