HomeMy WebLinkAboutHomestead_Zenthoefer STATE FORM 53569(R2B-09) TREASURER FORM TS-IA I
APPROVED BY STATE BOARD OF ACCOUNTS.22009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1-22-8.I
11311KOSIACSM KI:01= UU alataollilk,W ' R BOP fi° Y OO % NI A
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
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 a PR l ill-YWOJIMKTIM
Taspaver Name Property Address State Parcel Number Leal Description:
Roger W Zenthoefer 114 S Damosa DR 26-18-36-403-000.408-009 013-00408-00 WEST HGTS 2ND
Haubstadt IN 47639-8159 ✓ ADD 114 B
Complete and return to:
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PAM&MUIPATEICIRRILTBATitrilc9
Owner 1 First Middle Last
•
fJ51ctL �` N /�L ce-
Malig Address( ber ar street,city,state and ZIP code) Same as property address
SP....s /
first h4dtlle Last
Mating Address(number and street.city,state and ZIP code) Same as property address
Social Security Number(last 5 digits) Drivers License State ID Number(last 5 digits) axle Other(please speedy in Pan 4 below)
PARTAMELIOMA ION -
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
U43 ADDITIONAL INFORMATION - -
•
STATE FORM 53569(RIG-09) TREASURER FORM TS-IA I
APPROVED BY STATE BOARD OF ACCOUNTS,,200009�p,p�y��,���y�Iy y��� y��� ����.,�y yPRRE�SCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.I-22-6.1
Ia 0 ° Gta On I CQZ UV lajtat, VIL�JU LGt1LJ nip)0 a ° Q n..:. a :
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
buses higher tax bills for all; therefore, HEA 1344-2099 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.
0naltr]s PRO ER1 Y `IJJLXIO t n1 ION-
Taxpayer Name Property Address State Parcel Number Legal Description:
Roger W Zenthoefer 114 S Damosa DR 26-18-36-403-000.408-", 013-0040S-00 WEST HGTS 2ND
Haubstadt IN 476394159 ADD 11413
Complete and return to:
GIBSON COUNTY AUDITOR, lOt N MAIN PRINCETON IN 47670
P �4 1.17Q3; r b TION
Owner I O First Middle Last
•
erg— fke)
Mang Address(hanber weal city,state and ZIP code) I .
l Same as property address
Social Security Number(last 5 digits) Driver's Ljcense,State.ID.Ntmbettlast 5 digits) Slue Other(please specify n Part 4 bebw)
b- ass y -.�kIfS 9 . c ti
,First I Middle •—_ Last
Mang Address(number 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) slue Other(please specify in Part 4 below)
•
• PAR I$@=MO= ION
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 �J� Date Telephone � y /,
d' .- tor fi'` i�/0 (O ' ]
spouse Signature VV Date Telephone
•
PCB 103 ADDITIONAL INFORMATION
•
CLAIM FOR HOMESTEAD PROPERTY TAX FORM
E!
CREDIT/STANDARD DEDUCTION Hcio
State Form 5473 (R2 / 5 -92)
INSTRUCTIONS: See reverse side for filing instructions.
.. . CFRTIFICATION BTATFMFNT -I
I IWeI (.,_�� _ _ _ �- �y that a e1% � y of
pi as ou rincipal place of resid nce t following described e I property for which omesiead Plopettax remit i. 6y lai ed:
J I (We) owned ❑ Are buying under contract 4�/�ppqq 1 LL�a.'�oIf (�fCC
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the propert y or iy��ggtpueg9mairact.
CONTRACT RECORDED
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
FA
PROPERTY DESCRIPTI N
County Township ..
Tax. ici ci
a. el Vi r,_ 0O !gal description
It 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 BY CLAIMANT IN OTHER COUNTIES
County Township Co,ue ow
��eby certify the above statements are true, correct and complete. Sig lure of claimant
Adtlress (number and street, city, state, ZIP code)
2 2 I aL sv a 'un. E1Eer.Af 1rlU /!
ASSESSOR USE ONLY
TRUE TAX
VALUE
.ASSESSED
VALUE
HOMESTEAD
VALUE
NON-RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
S
Otherland
(2)
Signature of Auditor
Total land (line I plus line 2)
3
l)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pfus line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 _Pay 19_
I .
Lesser of 112 Homestead
S
Valuation or $2,000
Signature of Auditor
Date sign e —