Homestead_Weber STATE FORM 53569(R318-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-LI-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
,ipS anauses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
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.
. PARTI: PROPERTY IN ORMA ION -, - -
Taspacer Name Property Address State Parcel Number Legal Description:
Alan)Weber
417 BRADLEY DR 26-23-06-301-000.394-009 SUNRISE ACRES 6/7
HAUBSTADT IN 47639
Complete and return to: IEIIODiDODOREI®ICp f 0d IWml®IP DI®ml®
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 W LLl lB IW LI
PART.2:TAXPAYER INFORMATION .
I Fast Middle tact
(4n Dame_5 ✓ . lve_�er-
Ma4ing Address umber city,state and ZIP code) [ �,c, /� A/ c(-7 CFI !'a IeY Pr, to v 7 G 7 ' L c address c(-7/ cr
�CV,/�/ Last
f(, ma0Crl J!
Malting Address(number and street city,state and ZIP code) I Same as property address
- - PARTS:CERTIFICATION - -
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 • this property.Each undersigned also understands that,by claiming additional homestead deductions unlawfully,he or
she maybe liable for back : and substantial financial penalties.
Omer 1 Signature Date
',, - ( •PART 4:"ADDITIO\ALINFORMfTtON :-.. - .
FILED
NOV 2 '2012
c�.m�,
vC�
GIBSON COUNTY AUDITOR
CLAIM FOR HOMESTEAD PROPERTY TAX R R"I
CREDIT/STANDARD DEDUCTION �002
State Form 5473 (R5110 -01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
Kff;.:T '- - L- 7--- " . A ' 1 CERTIFICA TION STATEMENT
I (we) fl[,t�4 &IJ I AT c'rIj1,,'6eW' &rkR7I st day of March, 20
7 (We ccupied as our
I cipal—p=6 7®r7es=ente ti-fee' following 'clescii1bed real property for which a Homestead Property Tax Credit is hereby claimed:
I (me) I 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
-'—XONTRACT'RECORDED:'
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
-PROPERTY OWNED SYCLAIMANT IN OTHER COUNTIES
"PROPERTY'DESCRIPrrION.
County
Township
Taring district (afz, tow township)
I I
3'�0-3
Legal notion Is the property in question:
111Z ❑ Real property ❑ Mobile Home (I.C. 61.1-7)
If 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.
-PROPERTY OWNED SYCLAIMANT IN OTHER COUNTIES
County
Township
County
township
I hereby certify the above statements are true, correct and complete.
S1 at a cl imam
ress (number and street, city, state, ZIP code)
1--tS TAN DA R D. D E D U CTI 0 N ALL OWAN C E
U
ASSSSED VALUE
E00
HOMESTEAD
'NON-RESIDTIAL�,,-,
EN
VALUE.
AT,1 ..OF.TTV .
"n
Land not exceeding I (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvement,
Garage
(5)
ti
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 pits line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
1--tS TAN DA R D. D E D U CTI 0 N ALL OWAN C E
20 _ Pay 20_
Lesser of 1l'2 Homestead
$
Valuation or $6,000
Signature of Auditor
Date signed V