HomeMy WebLinkAboutHomestead_BorneCLAIM FOR HOMESTEAD PROPERTY TAX FORM AR
} CREDIT /STANDARD DEDUCTION HC10
.,,; • State Form 547 (R2 5 -92)
aTs
INSTRUCTION See r instrucm.,
V) V�, 1 _ T _ _ r` v y' -- certify that on PIE March, 19
occupied as o principal p a o residence the following described real property for which a Homestead Properte
�We) owned ❑. Are buying under contract
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or iSblNipg under �LOntract.
i
_ CONTRACT RECORDED - _
It buying on contract, Fee Simple owner's name - AUDITOR
Recorder's office where contract is recorded Record number Page
F1
PROPERTY DESCRIPTION
County
Township
Taxing district ( w nsho)
Signature of claimant
E.
P„yy'p3ber O ^,�, (n
Legal description
If any portion of the residential structure or the land not exceeding one (1) arse 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
Weby certify the above statements are true, correct and complete.
Signature of claimant
E.
dress (number and street, dry star ZlPCOde)
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON-RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
111
Other land
(2)
Total land (line I plus line 2))
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
_
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is true. correct, and
complete.
Signature of Assessor
Date signed
ing action - Signature of Auditor
Date signed
19_Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
STANDARD DEDUCTION
S
STATE FORM 535e9(Pi/8-10) TREASURER FORM TS-IA
APPROVED BY STATEBOARD OF.ACCOUNTS.MI PRESCRIBED BY THE DEPARTMENT OF LOCAL GOvUINME.vr FINANCE IC 6-1.1-224.1
Gibson County Auditor: IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
Princeton, IN 47670 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
\ T T T nm
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
1 jJ Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
APR 2 6 2011
Taxpayer Name Location Address
C. .N Borne, Donna S
v V\ 107E Gibson
GIBSON COUNTY AUDITOR
Haubstadt IN 47639
2693
Donna S Borne II I III III�II I �IIII_I�I�IIII�111�I�II�II_II�III�I_IiiIII I��II�II II I I�II
107E Gibson St
HAUBSTADT IN 47639
State Parcel Number Legal Description
j .26-19-31-301-000.048-009 /PT SW 31 3 10.208 AC — __
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORMATION
•
O. . I First - Middle - Last
OOM@4 Sue 8orwl; -
Mailing Address(number and street,city.state,and ZIP code) D-<rne as property address
to -2 6th5ou S -I-. - •
- -
Spouse First _ Middle Last
CIWrn I- ce 1Orunt
Mailing A d d rt s s(N t i i n b e a c i d s t r e e t,c i t y,state,-andZIP code)—. — — _- -_—--.1 S e as propertyaddresc —
(0 -) G t tp ',o •` S 4
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 1 Signature V !s-�' 1 J��,t Date
PART 4: ADDITIONAL INFORMATION .