HomeMy WebLinkAboutHomestead_Wagner STATE FORM 53569(R315-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY TEE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.I-22-8.1
IMPORTANT NOTICE TO 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
liuses 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 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. •
PART]: PROPERTI' ,'FOILDIA ION
Taxpayer Name Property Address State Parcel Number Legal Description:
Darin P Wagner H I S VINE ST 26-19-31-303-000.374-009 ORIGINAL PLAN 216/217 PT
HAUBSTADT IN 47639
Complete and return to: 111110 E1III111flln1DD®11'11®117mfU011nmmlllm®
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 ¢II 11J LL W! IL1
PART 2:TAXPAYER INFORMATION.
Owner I First Middle Last
00//1/ Sea AlfC/tie0
Maaa'uuf44dress(minter and street.pry,state and ZIP code)
r' D� �� I Same as property address
/
First Middle Last
•
mating Address(nunter 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) Sae Other(please specify in Part 4 below)
PART 3: CERTIFICATION
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is Mr.
rue 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.
Owne9rn24 re Date
( )
'PART 4: ADDITIONAL INFORMATION -
I ILE
TI 9-aff2
C.'J.IYb. .._.
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GIBSON COUNTY AUDITOR
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (Re 14.03)
Prescribed by the Department of Loral Gm emment Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
F11,FD
I (We) certify t on the 1 st day � March, 20 41
I (We) occupied as our p cipal pla of residence the following described real property for which a Homestead operly Tax C tf,"IIerreby Im
(We) owned ❑ Are buying under contract GIBSOtJ COU T<J Y AUDIT
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.
'�i- `'.!Mti .%f. lC0NTRACTyRE_C0RE) ED''';
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
. •-' i.,:v` ix:..t- ?h.'aiu rs v'.. M- AFiRDP,ERTY
DESCRIPTION .°�- 7',"r' '.T* ; _+ r' ?s`u'she`u'+ .$? �3�rt.•.._•.- °a`�_;i`< <'
County
Tow Ship
Signature of nt
LP A
Taxing
isbict (city, town, township)
Parcel number
O
Legal description
,TRUE�'TAX>'-
Is the prope in question:
Droperty, ❑ Mobpe Homo (l. C. &7.1 -7)
N any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
Of the property utilized to Produce income.
�..:x.APROP,ERT.Y, OWNED; BY ;CLAIMANT;IN�,O'LNERCOUNTIES'�'
County Tavnship
County Township
I hereby certify the above statements are true, correct and complete.
Signature of nt
LP A
Address umber aqd sh�ge1,',Clate, Ire)
L'
`ON s. t'1
,TRUE�'TAX>'-
ASSES9ED,NALUE
HOIdESTEAD,
�r NON tES1�ENTIAL .-i
- =n. _. Yrc`.:.,2.:!`4'...t— x�•.a,�,."S
i��YALUEx��;AT.f100%°OET67Y
^.
VALUEa`",..!•.�y
iS,iYALUE,.a�.z
Land not exceeding 1 (one) acre immediately
(1)
��"•; 3'z:+�y '' t;?'c }"' -'
r•
surrounding residential improvements.
��•`"^'_' `r'yt'^t7`
Other land
(2)'�r.'rrKYt
a5ps•t " •r4
Total land (fine f plus line 2)
(3)
Dwelling
Residential Improvements or Annually'"'
Assessed Mobile I AlenufaWUed Horne
Garage
5
()
T�
r -,•
irn,-�•.,�,�,,
¢,s
Other improvements
(6)
•;;'y:�r its,.
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(e)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
•-. ,rigs » �e•*s } :f..t7de; G'!�!`. DARD;' DEDUCTION' ALLOWANCE :.._,.,_z,ur,, .Y_y';',' =.,r. . _ :?_.»�. 'i • ;'- isv'Crt.::_'_:
20 _ Pay 20 _
A
Lesser of V2 Homestead
vatuetion or $35.000
Signature of Auditor
Data signed
V