HomeMy WebLinkAboutHomestead_Elpers (8)CLAIM FOR FOR HOMESTEAD PROPERTY TAX F YEAR
CREDIT /STANDARD DEDUCTION HC�o
` ` Slate Forth 5673 (R817 -07) \V "
Prescribed by the Department of Local Government Finance 09
INSTRUCTIONS: See reverse side for filing instructions.
I (We) Y certify that on the 1 at day of March, 20_
1 e) 'ad as principal place of res' once Bte folbwing described real property for which a Homestead Property Tax Credit is hereby claimed:
I (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 is buying under a contract.
CONTRACTRECORDED
If trying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
ASSESSOR USE ONLY
TRUE TAX VALUE
ASSESSED VALUE
I HOMESTEAD
NON-RESIDENTIAL
« 43,000 for 2009 pay 2010 40,000 payable after 2012
PROPERTY
AT 100% OF rry
County
Township
Land not exceeding 1 (one) acre immediately
Taring di (lay, town, township)
Parcel number
Leegal description • 7 ai S A C
Is the property In question:
(
surrounding residential improvements.
sa) le)
❑ Real property ❑ Mobile Home (IC 5- 1.1 -7)
o arty portion of the residential structure er the land not
of h% property utilized to produce income.
exceeding one (1) acre that immediately surrounds that str cture is used m produce income, describe the use and portion
a60- /q, 31- goo -
00D. 119 -00 9
ASSESSOR USE ONLY
TRUE TAX VALUE
ASSESSED VALUE
I HOMESTEAD
NON-RESIDENTIAL
« 43,000 for 2009 pay 2010 40,000 payable after 2012
AT 100% OF rry
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
`'i ';:'_4
surrounding residential improvements.
Other land
(2)
' +, e�•r'' -�''
Yr ".'
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
'. e
"'�+,•'vr Gq
Residential improvements or Annually
„'r -,- }-.=
(
-. „`-"` L"F '�y—• -„�.' ".
Assessed Mobde l Manufactured Home
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through fine 6)
•(7)
Total value (line 3 plus Gne 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day. year)
STANDARD DEDUCTION
20 _ pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser e of ad d Valuati on 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead
$
« 43,000 for 2009 pay 2010 40,000 payable after 2012
S' naWre of Auditor /T
Date signed (month. day, year)
STATE FORM 53569(R3B-l0) TR:aSURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I-I-22-8.1
' ^." ' ;:INFO +a 'NO ; Ie 1J0 HO " ...'S Al ' ' O ' YOW • •-
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
" 'duction 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. I: PROPER INFORMA ION
Testator Name Property Address State Parcel Numher Leal Description:
Jay Elpers 403 E GIBSON ST 26-19-31-300-000.119-009 PT NE SW 31-3-10.7215 AC
HAUBSTADT IN 47639
Complete and return to: MBIIIII[111 1111.1II:I1[[[IIIm IOU 111111 HIM!In Ill 1@I11OE
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
rf '� eR/ . Ps, riarillErAttliTh
Owner I Firsts Middle Last
Mailing Address(number and street,city,state aria ZIP code) Same as property address
Y03 �. (�QSO it,- s/ Ir-3 V 26 39
Last
Mailing Address(number and street.city,state and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number(last 5 digits) Sate Other(Please specify in Part 4 below)
< . . . PAR 3: CE'' ,IFICA• 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 xes and substantial financial penalties.
Owner I Signature Data
- • Sat
IL
•
JAN 7 2013
GIBSON
COUNT '" pl