HomeMy WebLinkAboutHomestead_Ottman STATE FORM 53569(R3IR10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,21129 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE 1064.1.22.8.1
- IMPORTANT NOTICETO HOMESTEAD,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
ifruses 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.
-- PA'TI: PROPER Y INFORMA ION `
Taxpayer Same Property Address Slate Parcel Number Legal Description:
David S/Shannon R Ottman 101 S VONNA LANE 26-18-36-403-000.097-009 WEST HGTS 2ND ADD 101 B
HAUBSTADT IN 47639
Compete and return to: I®II17f1,711PFlEl*IODMI l IMIMI IMMI
_ _ __ __ - _ GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 t WItW U9
. PART 2: TAXPAYER INFORMATION I
Owner 1 Fuss Middle Last
Mailing Address(number and streel,dry,state and ZIP code) Karr. ess
Middle Last
Maii g Address(number and street.city.state and ZIP aide) tP5
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is e!igible.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:ADDITIONAL INFORMATION • .
•
•
CLAIM FOR HOMESTEAD PROPERTY TAX L7� YEAR _
CREDIT /STANDARD DEDUCTION
rm
State Fo 5473 (R614 -03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling insintctions.
I (We) Y t certify that on the �lst�da Erer SeD
I (We) occupied as our principal place of residence the following described real property for which a omestead Property 'RC yre�i
❑ l(We)owned ❑ Are buying under contract Flo
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buyinj uu jer f c ntc Ut.7
If buying on contract, Fee Simple owner's name
IBSON COUNTY AUDITOR',
Recorder's office where contract is recorded Record number Page
P, R0 0 ERTY <6ESCRIPTION'=,_�,,,,- „`�.`�i�
County
Township
Taring district (city, town, township)
Parcel 9Y.([�ber
Legal eWn 'o
Yi"`_UE`4't�,�s:
SAT 100 %OF,TTV
VALUE. wa�vxSVAI:U
Is the property in question:
1 ✓
1 O
DateTd/ i- D
❑ Real property ❑ Mobile Home ( /.C. 6.1.1 -7)
If any portion of the residential structure or the land not exceedin a (1) acre that immediately, surrounds that structure is used to produce income, describe the use and portion
of the prop” pprroopJ'erty utilized to produce income.
Other land
2
()
Y ?= '�z �z:. �sSx�' � .'�e"�+��'��PROP.ERTY,OWNED'BY CLAIMANT IN' OTHEf2' COUIJTIES'���'�:i'i+r'.'�&°`•�. -•?may' 4'tiS)?'�£3��
County Township
County Township
I hereby certify the above statements are true, correct and complete.
Signature c t
dress (number and street. city, state. ZIP code) _
.i�y'Y4ML •P #Srrry wi .�' ., �jJ, S
ASSESSOR USE ONLY- '`+'t`r` r'
xiL
@ TRUE�TAXi r.
ASSESSED VALUE
_
HOMESTEAD
x - p
NON = RESIDENTIAL T%
Lesser of 1t2 Homestead
Yi"`_UE`4't�,�s:
SAT 100 %OF,TTV
VALUE. wa�vxSVAI:U
Land not exceeding 1 (one) acre immediately
1 O
DateTd/ i- D
surrounding residential improvements.
Other land
2
()
' -f`•. `
'
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
gg
,- ?',.?'
'Residential improvements or Annually
-A;p u;
Assessed Mobile I Manufactured Home
Garage
Other improvements
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of/wdilor
Dale signed
STANDARDDEDUCTIONAL[OWAMCEn ,-�"';�4:F
20 _ Pay 20 _
Lesser of 1t2 Homestead
valuation or 535.000 ES
Signature of Auditor
DateTd/ i- D
C %�M