HomeMy WebLinkAboutHomestead_Stuckey STATE FORM 53569(R3!5-I0) TREASURER FORM TS-IA
APPRO\'ED BY STATE BOARD OF ACCOUNTS,2109 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1 22.8.1
IM'PO ' MU'NO L •EVC)H0MI -6 • Al) ' '-O ' 0 Y 0 W +RS
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
Illauses 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.
. 196=13S 'R o 1F Ko alitrai
Taxpayer Name Property Address State Parcel Number Leal Description:
Billy W Stuckey Jr 9282 E SR 168 26-20-15-204-000.068-002 PT NE 15-3-9.52 AC
MACKEY IN 47654
Complete and return to: I®111II1.IIID IIDIIII11ILJGOBIIJII]DhIID
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
&TeAMitig2 INFORMATION
Owner 1 First Middle Last
I Iv (4)
Malting Address( umber and sweet,wry,state and ZIP code) J
Same as property address
gaga c s 2 ins � 4c_ w k) L- 7co
.sal First Middle Last
Mang Address(number and sweet.Ply.state and ZIP code) Same as property address -l
Social Security Number(last 5 digits) Drivels License/State ID Number(last 5 digits) sum Other(please specify in Part 4 below)
MOD ION •
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
Spouse Signature Date Telephone
( )
PART 03 ADDITIONAL INFORMATI9 -
FILH �•
• NOV 9 7012
•
GIBSON COUNTY AUDITOR
3
/
/ CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION Hcio
,��_�< • State Form 5473 (132 15-92)
rar.
INSTRUCTIONS: See reverse side for filing instructions.
Hq
- PROPERTY DESCRIPTION -
LL
County
Township
Taxing dist rrW1
to sh' )
ar I n er
S-oo
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 COUNTIES.
County
Township
Court
Tinwrighin
I hereby certify the above statements are true, correct and complete.
Si nature of claimant
ress (number and street, city, state, ZIP code)
ss zN �
- 'ASSESSOR USE ONLY
TRUETAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTULL ,.
VALUE -
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)'
Total land (line I plus line )
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
- -
Other improvements
(6)
-
Total improvements (line 4 through line b)
(7)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is true, correct. and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
Signature of Auditor
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000