HomeMy WebLinkAboutHomestead_Settles STATE FORM 537569(FL a-09) TREASURER FORM TS-IAI
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.1-22-8.1
IMIPOO AN Mar=In)1slr0��1 7UL��lO ' ' 0 'Cg' U1l @Mna
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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
0auses higher tax bills for all; therefore, HEA 1344-2099 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.
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Tasnaver Name ier .perry dress State Parcel Number Leal Description:
Aaron P Settles P O 16 26-14-19-103-000.488-006 003-00488-00 PT NW 19-2-8 1.877
` Some file 47683 AC C-I
Complete and return to: \\ •
. GIBSON i • ' Y AUDITOR, 101 N MAIN PRINCETON IN 47670
PART�4 rh INFORMATION " T-• .5 °° `
Owner I First - Middle Last
Aro it to Malang Address(number and steel,try,state and ZIP code)
Same as property address
/ISM$ E. 266 Sots— - t OqL144 Cif`% , TJ 47640
4 -
Mang Address(camber and steel ray,state and ZIP code) Same as property address .
Social Seamy Number(last 5 digits) Driver's{Liic ecenssepState IIID �
•
D Ntasibe�r� s)
(last 5 digits))) state se Other(please specify in Pan below)4 below)
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 I S' Date
( )
l `Uv$ADDITIONAL INFORMATION
ill
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CLAIM FOR HOMESTEAD PROPERTY [AX FORM
CREDIT/STkNDARD0EDUCT|ON
State ' �----------]
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Prescribed oy the Department u Local Government nowc`
INSTRUCTIONS: See reverse side*/^awivs/no/ionc
I (We) Le4 a nqiq I !Z,- j r f - il a certify that on the I st day of March, 20__
.`,,"/ .p.".wpu/place m/",wm/c*mo/mmwxouoeoun000n`mpnpenymr which anmmopaaopmpenynmcmd|t|shoehydaimoo:
/(vve)mwnod LJ/�obo�oyunder onotmct
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.
If buying on contract. Fee Simple o"er's name
Recorder's office where contract is recorded Rewrd number Page
county
Township
County nship
Taxi to", township)
R.cel number
Legal description
Is Ilie prope5p . n question
Date signed
Va. AM
-AMIOOVOI�jzW�
U my portion of the residentfal structure or the Land not exceeding we (1) acre that immediately suffounds that structure is used to produce income, describe the use and p�n
of the property utliz� to produce income.
County
Timmship
County nship
I hereby certify the above statements are true, correct and complete.
Signature of claimant
Address (number and stwt, city, state, ZIP code)
Signature of Audi
Date signed
Va. AM
-AMIOOVOI�jzW�
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Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
I'M K
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
INM
U
Residential Improvements or Annually
RIME
Assessed Motille I Manufactured Home
Garage
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(8)
I hereby certify the above is true. correct. and
Signature of Assessor
Date signed
complete.
I
Van" action - Signature of Auditor
Date signed
20 Pay 20
Lesser of 112 Homestead
valuation or S35.000
S
Signature of Audi
Date signed
Va. AM