HomeMy WebLinkAboutHomestead_Brittingham (2) •
515Th FORMUJtt jCI I TREASULER FORM TS-IA
APPROVED BY STATE MHRMOI,M YR:NrS No. Prr9LAJBEp BY WE DEPARTMENT OF URA].rAYERVMEA'T FD.•SCE ICVr.I-U4-I
Gibson County Auditor
..101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 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 femal.homestead fraud causes higher tat bills for all:therefore.
• HEA 1344-2009 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 he kept confidential and can only he 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 1:PROPERTY INFORMATION
Taxpayer Name Property Address
Brittingham, Frank A/Marlene S
RI Box 113 A
Patoka IN 47666
285
Fr. k A/Marlene S Brittingham
5078 N 775E State Parcel Number Legal Description
Patoka IN 47666-9145
I I I n I I Il IIllllIInIlnIr Inul liItnIlIlIlInv IIu 1lInl II 26-06-16-100-002.785-017 009-02785-00 PTENW 16192.00 AC
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORMATION
Owner I , ,! First UL+ D Middle (6 ` / Last
along Address(number and street,city,state,and ZIP code) Same as property address
Spathe-
', First n Q Middle z)t _1_j��nsx�y.1� last
tV\J L ,�,,r dill/�
Mailing Address(Number and street,city,state,and ZIP code) ' rn:trot as property address
PART 3: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 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
PART 4: ADDITIONAL INFORMATION
•
a%
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
; State Form 5473(132/5 -92)
au
INSTRUCTIONS: See reverse side for filing instructions.
FORM
na•'}IIj � I
FIB D t A
re 2 41995
�I (We't--�� �j � Z,{'f(��! iY� certify that on the tst day orWrc7i; 19
I rwe) oc led as our principal place of residence the following described real prope or which a Homestead Property Tax Credit is hereby claimed:
l(We)owned El 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.
CONTRACT RECORDED
If trying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
"
PROPERTY DESCRIPTION
County
Township
NON-RESIDENTIAL
VALUE
Taxing distric
(c , t n wn hip)
601'e-,W `-
Legal description
Da(p- 4gnad_ 4
Otherland
I j —1-9
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that stmclure 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
T
eanmy
NON-RESIDENTIAL
VALUE
I hereby certify the above statements are true, correct and complete.
nature of claiman
�-
bless (number and street. city, state, Z node)
In. -/7666
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON-RESIDENTIAL
VALUE
Land not exceeding I (one) acre immediately
surrounding residential improvements.
(1)
Signature of Auditor (�
Da(p- 4gnad_ 4
Otherland
(2)
Total land (line I plus line Z)
3
Residential improvements
Dwelling
(4)
-
Garage
(g)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pfrs line 7)
(g)
1 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_
Lesser of 1/2 Homestead
Valuation or $2,000
$
Signature of Auditor (�
Da(p- 4gnad_ 4