HomeMy WebLinkAboutHomestead_LytleCLAIM FOR HOMESTEAD PROPERTY TAX
__ STANDARD / SUPPLEMENTAL DEDUCTION
Stata Fwm 5473 (R73 / 12-09)
� y� � Presaibed by the Departmem of Local Gwemment Finarxe
IN57RUCTYONS: See �everse slde forfiling insWCGOns.
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�(We) G certiN that 1(w�� .°mPigdas-mY (our) prindPal
p�ace of residence w am (are) buyifg the tol 'ng described real properry fw whirh a Homestead Property Tax Sfandard Deducti0 is reby daimed
u�der contrad on ihe date this application is filed, (date o7filing). I(We):
�{ GIBSON COUNTY AUDITOR
XV Own ❑ Am (are) buying under recorded contrect
�Q Am (are) entl0ed to occupy as a tenant-stockholder of a crooperative housirg wrporatlon
❑ Have a bene5cial interest in Ma Wst or the right to axupy the properry under �he lertns of e qualified personal residence trust .
❑ Am (are) the shareholder, partner or member of the enlity ihat owns the property.
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If buying on conuact, Fce Simple amefs �me
RecorAeh offica xAre�e contrarl is iemrded Recard number Pape
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�My Tawnship T ' � (cill: rown� rownshiP)
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Pafrel number L��tion� Is tha in Question:
aG �- �,�,,, ❑ �,�M��a��,�6,.,_n
If arty portion of Me residential sWCWre or Ne IaM rwt ezceeding are (1) aae ihet immeOiatey �rIW� ihat stru�re is used m pfoduce inmrt�e, Cescriba ihe use and portim
W the proparty utltized �o protluce Inmme. � rf-/ f/
�- /,3 a0 - /o/- OUD./ �r-�-OO.S
-.• . .: . .
Counh ToxnshiP CauntY Townshlp
1 hereby certiry the above sta[ements are true, cortect and complete. signa o (�i,r/r�-a�n��� ���
v�c��-- 1.5�
Add jnumbe�antl sLeat, dry stete. a ZlPCOde) �� n �_ / �� �// (�
Ll L�li� ioci.. r1.M sJ /V Y l
V r.V i.J �V tf � �..�
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tand not axceeding 1(orre) acre ImmedWtey (� � '� �',� sy�'3,���;-�€�� ����r;�;
surtoundln residentlal im rovemenl5. -
f r s�''�
Other lantl (2) s s' i �.'_ ��"�
Tofal land (Itne 1 plus Ilrre T) (3)
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ResidentlallmprovementsorMnuafry �Iling (4) .,,?�y�<,t-�t"`..�r�,--'�.-�� t��
Asaessed Mohile I ManufacW red Home 9 ��3< y'�`" ��'r'� '���; :+''�_�
Gara e is) �:::.-w . �». _ -sx 'v.4¢ ��i
ONerimprovements (C) s� tia�� �'.
� �. � �,.
Total improvamenb (Itna I Nrough line � (7)
7ota1 value (line 3 pha llne n (8)
I hereby certify the above is We. cortect, �9��re ofl�ssessor Da1e signed (montn, deY. i��
and wmplete.
v�y� eaim - s�ynew�a m a,a�mr
Date si9ned (monM. daY• Y�/)
.... � . . .
20 _ pay 20 Lesser of 60% of the essessed value of the homestead or $45,000
NoMiMSfand4g any oMerOrovision, Ne sum o7Ne deductions provldetl in IC 61.1-f2 to a rtwW7e fame IAat is $
not assesmtl as real property or to e menNacfured home Nat is not essesseU es real property mey not exceeE
one-heH (12J olMe essessed veNre W the mobBe hw�re ormenufectured lame.
Si�aNre W/Wtlitw Date si9ned (month, daY. Yaei)
. . . ._ ________________'___'__"____'_"'_'""'__
STATE FORM 53569(RM-10) TREASURER FORM TS-IA
APPROVES BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE 106-1.1--222-5.1
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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
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.
PAR I: PROPER Y INFORMATION • r :'
Tunaver Name . Property Address $Isle Parcel Number Legit Description:
Robin D Lytle CENTER ST 26-13-20-101-000.174-005 1V&NI ADD 2 PT
FRANCISCO IN 47649 pp�� NW NW 20-2-9.21 AC I�E1�II 'VIIpI
Complete and return to: I�1IW111113[11�01E�0IE��I111�LL11111�1111WI��ISYu
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2: TAXPAYER INFORMATION ::7 .:0:
Owner 1/o e / l • First Middle LV l L F Last
Mating Address(number and street,city,state and ZIP code)
1O •gaX J5 rAR-n 0-1 S GO ik) 14ei a e
Spouse First Middle - Last
Mating Address(number and street.city,state and ZIP code) Barns as
property address
Social Security Number(last 5 digits) Drivers Leense/Slate ID Number(last 5 digits) Stale Other(please specify in Part 4 below)
. .. . - .- . - - - 4 • • ,. .._ ...r u �m ...'•t46 :.
the
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 . bee Date
)
PART 4:ADDITIONAL INFORMATION;:;_ • • - - 5I'ks: ;w 44;',
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FILE I)
• OCT 17 2012
GIBSON COUNTY AUDI IUFt