Homestead_Venson STATE FORM 53S:9(248-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY 111E DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC61.1 22-8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
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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
: auses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
. s...ndard 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 flings.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 c_ou_nts officials eliminate
homestead fraud .
PART : PROPERTI I FORA ION M
Taxpayer Name Property'Address Slate Parcel Number - Lesai Description:
Steven N Venson 304 R'CHURCH ST 26-19-31-301-000.108-009 ORIGINAL PLAN 142/143/144 PT
HAUBSTADT IN 47639
Complete and return to: 1 111111LIMII IIIEE0 111Olm111111ffi®ONDmm®
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
. .. .. .
- PAR7 2:,TAXPAYER 1NFOR%IATION
Owner 1 Firsl Middle Last
Ste,,/n lu jis. Ven,t--n
Malang Address(nut and street.dry,state and ZIP code) [Ai same as progeny address
364 W. Ckw ATI Sf- JcJ t-iit 34 �I
- Middle Last
an dl --D( Vey,4soV1
Mailing Address(norther and street,city.state and ZIP code)
Same as property address
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 I Signature / Date x
':PART 4: ADDITIONAL INFORMATION .
Sfist.L_CF. nag- ovt Mocka on P -$Js -hme .
1 J
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CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
CREDIT/STANDARD DEDUCTION
I 6R1 MO
State Form 5473 (R6 14.03) f t
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions. APR 2 9 2004
I (We) ce
I (We) occupied as our p �ncipal place of residence the following described real property for which Homestead Property Tax Credit is hereby daimed:
❑ 1 (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.
. . — 1 1 1 NTRACTi'RECORDED
If buying on contract. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
FS Ff(jP.-EF&YbWNE6-B* CEk I" NITM05THE MW
County
�ship
county Tavnship
Taring dirt'
to
:316Uhk� �A
'ldreas (number and street, city, state, ZIP code)
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'74-39
I
be
Legal
the
' 4ope,.ty in question
Real property ❑ Mobfle Homo (I.C. 6-1.1-7)
If any portion of the residential structure or the lar
land not
of the property utilized to produce income.
used to produce income, describe the use and portbn
FS Ff(jP.-EF&YbWNE6-B* CEk I" NITM05THE MW
County
Township
county Tavnship
I hereby certify the above statements are true, correct and complete.
ure of claimant
'ldreas (number and street, city, state, ZIP code)
T
'74-39
g�
SS R,USE ON
d�. T
a StIri
04
Kffi9i'SiDV;rd'i
J.&HOMESTEADIg
WOgrE DE14�[A
at--GN I
E�--
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
W
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
OZZMA I
Other improvements
(6)
Total improvements (line 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
20 _ Pay 20_
Lesser of 1r2 Homestead
Valuation or
Date signed