Homestead_Carney •
!t{tE FORM!!w IR_/urvl ULSSUD FORM TS-IA
AITRON ED
IMPORTANT NOTICE TO HOMESTEAD PROPERTY ROWNERS
[Gibson County Auditor
101 N Main
' PRINCETON IN 47670 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 in bills for all;therefore,
® HEA 1343-200 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to recent the
benefit and to provide additional identifying information necessary to allow county go emnwirl to better monitor homestead
tiling-.This information will he kept confidential and can only he accessed by authorized county officials.The Derunmem of
Local Government Finance will sec this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Carney, Thomas ULinda D
--T' = - - - — RI 13ox \ ')
1 cIN 47619
1268 70 337 C /nc,;A Sl:
Thomas L Gamey S ay.e—rl .t\c 4. 517613
PO Box 273 State Parcel Number Lezal Description
SOMERVILLE IN 47683-0273
IrIttIItttItIItt Irt Ittallrll Ilrtaitt llrit rrltt��r�ltt rl 26-20-02-404-000.180-003 020-00180-00 OLD PLAN 16PT
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•
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
` Last
111.6 AA as - Lj tJ rj C r1 L'
-_ - Address(number and street,city,state,and21P code) "--- - '- El Same as properly'uddra— -pp".�' - — -- -
` .o ? u\/[, x13 1033"7 C. 'AIN . IJ S"� SOrs.2rJ , (tc,L H 06 03
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Q O. 6 t . 411 10131 :- 01\11r1A ST I Sorn a v"v1 (to ` ( t�1 LL7L ?3
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 IiiiiSign:ture Date .
TART 4:ADDITIONAL INFORMATION
•
I (We)
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Fonn 5473 (R5110-01)
Prescribed try the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side for filing instructions.
as our principal place of residence the following described real
l(We)owned ❑ Are buying under contract
JUN 18 2003
for which a Homestead Property Tax Credit is hereby claimed:
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.
'RECORDED
- - - - - - - ... OKTRACT�
If buying on contract. Fee Simple owner's name
Pecerdees office where contract is recorded Record number Page
A I V�; �' !iPRGP -W =6 M--M-;L WPM- 41'
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County
(10
TONnship
County Tavnship
Taxing 0i1bict (city, tom, townsmi
ZK J
Parcel number
A0 -co
o claimant
ESM,
/
7 LU
Is
Is the prope �ty.
rty 1 question:
Real eal property ❑ Mobile Home
Vscture
If any port= of the residential structure or the land not exceeding we (1)
of the property utilized to produce income.
immediately surrounds tph.t Is used to produce income, describe the use and portion
t s tu
rk"=��01
IWdTHER
County Tovnship
County Tavnship
I hereby certify the above statements are true, correct and complete.
i at
o claimant
�1011W'rass (number and $beef, city, dy, state ZI
Sw )-/j 1 "5 A6 —t " 10 � �J' S ') '%� T- (?, � k L, 4-
DARD-MEDUCTION' rOANCE
' AL IL W
LlEi
WiSij
Lesser of 1/2 Homestead
at
-%T�OAWME�iffiIDIENMV
__,V
Valuation or $6,000
-U'!E
11A 90OA70Q
--VALJUE
7 LU
Land not exceeding 1 (one) acre immediately
, k -7
WiM
residential improvements.
W '- M 0
Other land
(2)
Tdal land (fine I plus line 2)
(3)
-Cgg- SV gl
Dwelling
(4)
Residential improvements
-
Garage
(5)
AN
A
Other improvements
(6)
Total improvements (fine 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
DARD-MEDUCTION' rOANCE
' AL IL W
20 _ Pay 20 _
Lesser of 1/2 Homestead
TS
Valuation or $6,000
Signature of Auditor
Date signed