HomeMy WebLinkAboutHomestead_Hurst (t. STATE FORM 53569(R3/-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1 22-8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
'°duction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
IPPcauses 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. -
',_ . T PARTI PROPERTY`INFORMATION
Timms er Name Property Addres3 State Parcel Number :ATM Description:
Paul A Hurst 10445 E BASE RD 26-13-I 1-400-001.334-006 PT NE SE 1 12 9 2.00
OAKLAND CITY IN 47660 C-I
Complete and return to: RIIM IIIIMI)illl►gEWPilliingLIIl i11( IN
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2:TAXPAYER INFORMATION
t First Middle Last
/4o j/1/ �w ,�° �
Mating Address(matter and street city,state and ZIP coo
�l f� r � Pro Dertyapdrasa //
/� 77 k ,. acr !� . - �� opwA C--iA iw N7 (b�
spouse //(n// First Middle Last
/ V OAL(
Mailing Address(number and street city,state and ZIP code) Same as property address
Social Seaaity Number(last 5 digits) Drivers License/State ID Number(last 5 digits) state Other(please specify in Pan 4 below)
t _ •• 1. • TI 1 T- .. .-...`•/.1,1==.'`e tai-.14
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
home�s4t�1�--d standard desuction on t is property.Each undersigned also understands that, by claiming additional homestead deductions unlawfully,he or
she Iii�it- liabl- .1.11: taxe an substantial financial penalties.
art��%j -
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V--- 4Z_,
,£ ;;; .:" ;+',-`
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a/ CLAIM FOR HOMESTEAD PROPERTY TAX Fo
a'= CREDIT /STANDARD DEDUCTION HC1D
State Form 5473 (11215 -92) -14
reu 1
INSTRUCTIONS: See reverse side for filing instructions. -
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CERTIFICATION STATEMENT -
- I've) _ –Q_� K S,r c?i, K 11 ( certify that on the 1st day of March, 19_
a6t) occupied as our cipal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
irl(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 the property or is buying under a contract.
CONTRACT RECORDED
It buying on contract. Fee Simple owner's name ,
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County -
Township
Taxing discs (city. fawn, township)
Parcel number 013 Z {,d
Legal descriplion
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. /
Address (number and street. city. state. ZIPcode)
Signature of Auditor
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
®eby certify the above statements are true, correct and complete.
of cl ima .
SigOf,
Valuation or $2,000
Address (number and street. city. state. ZIPcode)
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding t (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2,000
Signature of Auditor
Otherland
(2)
Total land (line I plus line 2) -
(3)
I
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pNs line 7)
(g)
1 hereby certify the above is true. correct. and
complete.
Signature of Assessor
I Date signed
tying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 —Pay 19_
Lesser of 112 Homestead
S
Valuation or $2,000
Signature of Auditor
Date signed
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