HomeMy WebLinkAboutHomestead_Cox (4) STATE FORM 53569 DUB-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,22009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1 22-e.l
- 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
IDcauses 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.
PARTI PROPERTY INFORMATION
Taxpayer Name Proper'Address State Parcel Number Lecal Description:
James U Cox
11498 E BASE RD 26-14-07-I00-000.213-006 PT NW SW&PT NW SW 7-2-8 1
OAKLAND CITY IN 47660 AC C-I
NOT niq cc.ddresc
Complete and return to: 1IlllM1'n',llI•nIII 1II1rr1111 rII�aa11 ,''IIIIVIII! IP91131I3I[ IIINIpIfilllCllH�yIII!I
Maass Address(cumber and street,city,state and ZIP code) Same as property address
Spdal Seamty Number(last 5 digits) Drivers License/State ID Nurnoe!(last 5 digits) State Other(please specify in Pan a below)
`�...__;: - _ v_.. __ �t .-s,.s -- P_�RTJ2•['FR1'IFI�ATLI L I Rk +-� ?tEi+11
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
FIT
NOV 7 2012
GIBSON COUNTY AUDITOR
rescr.Lx isf 6r-are ixaxa or Tax camassioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19-Z
..
are buyincr under oontract _ e: l - %Y % /�o -�G?� °7� - 4Q6
Q have a beneficial interest the .taxpayer
Property• Description in' County ( Township
Taxing District (City, Town*, Township) :
Parcel tttmiber or-legal despription shown on -tax statement:
If buying on contract: Owners name (fee simple owner)
Contract recorded in Recorder's Office - .Record No. =Page
If any portion of- the-residenti.al structxire or the land, not exceeding one (1) acre that
imnediately surrounds that structure is used to produce inane, describe the use and portion of
the property'utilized.to produce income
Any other counties in which individual owns or is buying real property:. County-. Township
certify the above statement is true, correct and c nmplete.
nature btreeL EiDuress - uUy ta,.c CULL Llj
*Individual either owns or is buying uner a contract that provides is to pay the
property taxes on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOW S-USE ONLY -
True Cash Assessed Hanestead
Value , Valuation Valuation
Land not exceeding 1 `(one) acre immediately
17
surrourziing residential improvements (1) %B'
Other Iarxd " °
Total Land
Residential Inprover!e,nts
other Improvements
To Improvements - Line (6) plus
I hereby certify the above is true,
• ..
Total • , 3.3,Y •
• '11111111111/// %///1
correct, . ..
iture of Assessor Date
L�
ACTION BY AUDITnR - p ,/
Approved; Date: �� a