HomeMy WebLinkAboutHomestead_Fulling (2) STATE FORM 53569(R315-10) TREASURER FORM TS-IA
APPROVED 9Y STATE BOARD OF ACCOUNTS.222009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-L622-e.i
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS ; ; >•_
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
-Aaduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud t
•.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.
1:1;'; _ PARTI: PROPERTY'INFORMATION
Tnpayer Name Property Address State Pa reel Numher Legal Description:
Steven W Fulling 194 N 1050E 26-13-12-100-001.408-006 PT SW NW 12 2 9 15549 A
OAKLAND CITY IN 47660 C-I �\P•
Complete and return to: 16E1I{II.IEiIEIi1 E'1iUBE1H :UB11JICtl1111111LtlG]iL IN 111
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 •
I _ . PART 2:TAXPAYER INFORMATION .''f.•;',
Owner I First Middle Last
T4F„e,J la)I KL L P11
a
Mailing Address(number and street,Qty,state and ZIP code) •
Same as property address
Spouse First Middle Last
Mailing Address(number and street,city,state and ZIP code)
2c1 1 Same as property address
Social seventy Number(last 5 digits) Dr'iver's License/State ID Number(last 5 digits) State Other(please speedy in Part 4 below)
t17441,44._ .x PART 3:. •ERTIFIC• TION 9 + �_ "�`'4'
>:14-� -k : _ . '�. .. - - ., �:+_.. .. aft w ... g ,�l
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 nature --- Date
it
FILED
NOV 2 6 2012
GIBSON COUrv1(Y AUDITOR
oaCLAIM FOR HOMESTEAD PROPERTY TAX
> i4 CREDIT /STANDARD DEDUCTION
) State Form 5473 (R2 / 5-92)
INSTRUCTIONS., See reverse side for filing instructions.
FORM
HC10
-rn -W -1 -C n
YEAR
CERTIFICATION STATEMENT
�°
I (We) {�✓ -2- /-L L / n� �j certify th1apt jTsgN jf March, 19_
1 (We) occupied as our principal place of residence the following described real property for which a Homestead Pro yi2rty I axl Credit is hereby cl '
❑ I (We) owned ❑ Are buying under contract
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns t p e ko ract.
GIBSON C0� T
CONTRACT RECORDED
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
To Mp
Taxing d Idcl (ci , lawn, township)
Parcel number
00'� - c/o 8' -00
Legal description
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.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township -
County
Township
ereby certify the above statements are true, correct and complete.
Sign
tur of c lai nt
-
Address mber and street, city, state, ZIP ) r /
ASSESSOR USE ONLY
I TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(2)
Total land (line I plus line 2)
(3) -
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
complete.
Signature of Assesor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Les o1 "' Homestead
V atio or $2,000
S
Signature of Auditor
Date signedp
—�O �O/