HomeMy WebLinkAboutHomestead_Perkins STATE FORM 53569(R3/840) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1 22-S.I
INME c .IMPO�RTUTINOTICE TO'H2OIVIEST�EAD PROPERTY WNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
'eduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
•Pauses 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.
j,- ,..:.L . -. .. PAR I: PRO',ER= Y INFORMA, ON. - sr'-- " -
Taspaver Name Property Address State Parcel Number Leeal Description:
Keith Perkins 1522 S 1125 E 26-14-19-200-001.410-006 PT NE NE 19 2 8 .7050 AC
OAKLAND CITY IN 47660
Complete and Ferr:n to: IIIIIIMHElIV(I1IIIIIDIIaII111V11111V11IIl]II1II'II11IV
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
,5[,li ,-Rr ;: �r,. •.``r`'P• RTo • TA. '' Y '[6 NF,1RM • TI r,. �_, .., : .�'rr.,,
Owner 1 4/ First - Middle h Last
LktiEi �t� �� w � �L oohs
Mailing A ess(number am sheet city,state and ZIP code)
Same as property address
Spouse t/ First / . Middle i Last
Mating Address(nurgar and street,oily,state and ZIP code)
Same as property address
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
'` :,
CLAIM FOR HOMESTEAD PROPERTY [AX
CREDIT/STANDARDDEDUCT|{]N
State Form mn(no/4-03)
--
Prescribed b° the Department m Local Government Firla^^-,
INSTRUCTIONS: See reverse side to, filing
m March, u0__
'.``", occupied ","= principal place m residence u` o oeoma/pmpenymr*m/*"anome�euurmpen�xa��mdxoxomby�aioed:
|Kmo>nwneo []aro»v�noun«e/nun»afling |8N10/U� Have uhenefido/iote/ouin the entity matioonh|e for the property taxes on the property and that owns the property v�rjs buying under acontract.
If buying on contract, Fe,e Simple owners name
Recorders office where contract isrecorded
Record number I Page
STANDARD DEDUCTION ALLOWANCE
Lesser of 112 Homestead
valuation or S35.000 S
NA I
�
County
PROPERTY DESCRIPTION
County
Township
I hereby certify the above statements are true, correct and complete.
S, atur f clalma:.nt
Address LQumber and street, city, state, code)
qw
Legal description
Is the pro que 'i
-VAL
Land not exceeding I (one) acre immediately
surrounding residential improvements.
If my portion of the residential structure or the
land not exceeding one (1) acre that immediately surrounds that strucItire is usad to produce income. describe the use and portion
of the property utilized to produce income.
(2)
Total land (line I plus line 2)
STANDARD DEDUCTION ALLOWANCE
Lesser of 112 Homestead
valuation or S35.000 S
NA I
�
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
S, atur f clalma:.nt
Address LQumber and street, city, state, code)
qw
VALUE
-VAL
Land not exceeding I (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements or Annually
Assessed Mobile / Mwufactured Home
Dwelling
Garage
(4)
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the abiove is true, coff ect, and
Signature of Assessor
Date signed
Verifying action - Signature of Podttof
Date signed
STANDARD DEDUCTION ALLOWANCE
Lesser of 112 Homestead
valuation or S35.000 S
NA I
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