HomeMy WebLinkAboutHomestead_AusbrooksCLAIM FOR HOMESTEAD PROPERTY TAX FottM
CREDIT/STANDARD DEDUCTION
State Form 5473 (R7 I 54M
Prescribed by the Deparbnant of Loral Govenvnerd Fnmee
INSTRUCTIONS: See reverse side for Ming instructions
CERTIRCATIONSTATEMEW. Vl'�
I (We) rm"Ja 4 \1 ) U–�u) NY LL-� I cofytaj& I& I st day of March, 2D_
I (We) occupied as our principal place of residence the following described real property for which a Honm pr*m ereby claimed:
I (M) owned ❑ Am buying under contract P, t E),
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the x4rtvTs,W rg contract.
f Fee Single ommes name
Obk:
Recordertofte -Im gb ctisrecorded
Page
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County
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PRoPmmqEscRjFnqw:,'--'.
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C—ty
ToWnship
Signature of dawnart
Tmang di
I
(cify, b
�m
M, 1 "17 76- x
Parcel number
Legal desanplion
—
Is the
-, X - Z,
W,
surrounding residential improvements.
.
1. 7UA
=n oMobile Horne (LC. 61.1 -7)
terry portion of the resiclantial structure or the land not exceeding one (1) acre that ummdately suffourkis dud oditure
m used tD Produce inmrne. describe the use and paruan
d the property ub(®d W pmduce in=ne.
4P, 13k —60 Cl
.'046PERTYOWNiMBYCLAiMA IN'O*ER60UNtMS�!l'
County
Township
County
Township
I hereby certify the above statements are true, correct and complete-
Signature of dawnart
mr— (nurnber anar street crtK state, ZIP=de)
STANDARD DEDUCTION ALLOWANCE.
TRUE TAX.
ASSgSSWVk:dg
-HOMSTEAD'
EVALUE
ASSESSOR USE ONLY
VALUE:
AT,10OF TTV
01W
T
Signature of Audrk,
Land not exceeding I (one) acre irryneduately
(1)
-, X - Z,
W,
surrounding residential improvements.
, � , N,
IN
Other land
(2)
Tdal land (lyre I pkm We 2)
(3)
Dwe lling
(4)
Residential improvements or Annually
Garage
(5)
q, �,`• Y.% ") 9:
Assessed Mobile I Manufactured Horne
Other improvements
(6)
.:1
Tdal ffnpruvernents (&* 4 &wough fine 6)
(7)
TctEd value (Ikm 3 pAs fine 7)
(8)
1 hereby car* the above is true, correct, and
complete.
Sqnature of Assessor
Date sipped
%ftT" actim - Signature of Auditor
Data signed
STANDARD DEDUCTION ALLOWANCE.
20_ Pay 2O_
Lesser of 112 Homestead
$
Valuation or $35,000
Signature of Audrk,
Date sped
STATE FORM 53569(R3/5-I0) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.222009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1-22-8.1
. IMPORTANT NOTICE TO::H.OiMESTEAD 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
•auses 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 1: POPE' Y :`FORMA ION .
Taxpayer Name Property Address State Parcel Number • Leal Description:
Robert W Ausbrooks 207 S WEST ST 26-18-36-404-000.136-009 PT SE 36-3-11 .2999 AC
UAUBSTADT IN 47639
Complete and return to: I®IMEEEINEIII7II�Ti t. ® [DII�B,YIOG:1�i1
. GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 I11 TI
PART T.TAXPAYER INFORMATION
Owner t First Middle Last
RO6ea VI/ /f}-n,-1 405B,woxc
Mailing Address(runter and street.city.state and ZIP code) /� f/�� I nie as p�rape/rry address
•
Ni FirY rsi5APe/fS
Magog Address(nunter and street,city.state and ZIP code) as rxopertY address
PART 3: CERTIFICATION
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 Signature Date
PART 4:ADDITIONAI.INFORN-IATLON ,