HomeMy WebLinkAboutHomestead_Tepool STATE FORM 53569(R2)5-09) TREASURER FORM TS-IAI
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.1-22-8.I
EcliP01'RTAhNT NOTI`CE TO H:ONIIESTE,MD 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
uses higher tax bills for all; therefore, HEA 1344-2099 requires taxpayers who receive the homestead
s andard 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.
EIMI208 PR ,R1.Y IN 0RM �9
Taxpayer Name Property Address State Parcel Number Leal Description:
o .oW8 S 9TH AVE
Harold E Tepool 31 26-23-06-200-000.789-009 ALTS DEUTSCHE START 24 PT
HAUBSTADT IN 47639 UNIT 4
Complete and return to:
• GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 -
/ P%Rt,T 1 4XPAYER INFORMATION
Owner 1 /14/412 4- First - .. Middle Last
510 s. cI1& A-Lie 1- 81639
Magog AAddress(number and street,city. Code)
state and ZIP de) Same as property address
/1711410 162 / ,rpoo
First Middle Last
Mabrg Address(number and steel,city,state and ZIP code) Same as property address
Social Security Number(last 5 digits) Drivers License State ID Number(last 5 digits) sate Other(please specify it Pan 4 below)
P.aRT� lt�
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 Date
( )
PART c03& INFORMAL
0
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDMSTANDARD DEDUCTION
Shate Form 5473 (R7 / &M
Pmacribad by the Deparbnent of Loral Govarnarard Finanoitt
INSTRUC77ONS., See reverse side for Ring instructions
'a) lZt I(JWVW 's I j. cm* that 20_
Tat tis clainned:
b) Occupied as our principal place of residence #Ve Mowing described real property for which a Homestead
I (We) owned ❑ Are buying under contract amo COUNTY AUDITOR
Have a beneficial interest in the enfity that is liable for the property taxes on the property and that ovirts the property or is buying under a oomnbacL
CONTRACT LL. _i,
tf bL"V on ..b Fee Simple owners narnet
Ftecordet's aRce whem contract m recorded Recud number Page
&,qLAmm"bl'oTHER COUXTEESI,1
PROPERTY DESCRIPTION
13 PT
W
Cunq (02,(16
Township
I hereby certify the above slabarrwrits are true. correct and complete.
-Ar-
Tmang district (ply, sown,
(nmkar and stn. orb. sbfig• ZIP rode)
'163
SC IXI-
VALUE
Land not exceeding 1 acre invnecliately
$
Parcel mffnbw
surrounding residential improvements.
Valuaboon or $35.000
property in ttuesoon-
of hAtor
Other land
(2)
el A
X
Red pup" ❑ Mobile Harris (W. 6-1.1-7)
If arry portion of the residential structure m the lad
dare properly W&md to pmekim erxxvrtet. =Vlorl'®re
A=Rxe
m used to peoduoe troornet. descrt)e ft tize and portion
Total land (Iffte I plus fim 2)
(3)
tc? L -c23
-6 In -
63' 60 - Coo 73K
&,qLAmm"bl'oTHER COUXTEESI,1
County
Tt:itinrtship
County
Township
I hereby certify the above slabarrwrits are true. correct and complete.
-Ar-
Signature Int
-
(nmkar and stn. orb. sbfig• ZIP rode)
'163
�7N ,
.,"
'ASSESSOR USE ONLY "
TRUE
TRUE TAX
'/AT
20_ Pay 2O_
P
100%'OF TTV
-VALUE
VALUE
Land not exceeding 1 acre invnecliately
$
51
Am,
surrounding residential improvements.
Valuaboon or $35.000
of hAtor
Other land
(2)
Data si®med
Total land (Iffte I plus fim 2)
(3)
Dwelling
(4)
ResidenlialirnprovetaentsorAnnually
Assessed Mobile / Manufaclurad Horne
Garage
ky
Other mvmvwmts
(6)
Tdal brnprwemerrts (Iirm 4 through kne 6)
(7)
ToW value (fame 3 pie fine 7)
(8)
I hereby certify the above is true, correct, and
complete.
Signa6xa oFAsaessar
Date signed
VM" action - Signatue of k4tor
Deft signed
STMOARO DEMICTM ALL'43111111411110E ��, Ilk'
20_ Pay 2O_
Lesser of 12 Homestead
$
Valuaboon or $35.000
of hAtor
Data si®med