Homestead_McKinney STATE eORM 535649(R3/5-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE ICS-I I-_2222-8.I
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
_Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
Auction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
causes higher tax 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 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:• PROPER Y`INFORMA ION •
Tanya ser Name Property Address State Parcel Number Legal Description:
Daniel K McKinney 6180 E 450 N 26-06-18-400-000.957-017 PT SW SE 18-1-9 8.234 AC
FRANCISCO IN 47649 C-I
-
Complete and return to: MIMED I CV011IlI�lU1 IDS Ia D s IIIIIffl fIIA®
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 lllUi 1UL W
- - PART 2:TAXPAYER INFOR,NIATION
Owner 1 First Middle that
�ANIEL K MLK1NOE ).(
Mailing Address(number and street.cii slate and ZIP code)
same as Property address
. . .
Spouse - First - .� Middle ) \� � � E y Last
CD NN \ V 1� N
Mailing Address(number and street.city.state and ZIP code) ��%'� Sarre 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 lazes and substantial financial penalties.
Owner I •s lure
0
Date
')'
'oe PART 4: ADDITIONAL-INFORMATION -
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (Ra / 7 -07)
Prescribed by the Department at Loral Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) LYE )(./ / that on the Vcy �r n�r[Gt�h,2g-
1 (We) occupi sour principal aco of residence the following described real property for which a H as ad party Tyr it is hereoylcY�lmed:
�(We) owned ❑ Are buying under contract lv1
ave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or isbuyi gynder a, ntrad.
CONTRACT ••D .
If buying on contract Fee Simple owners name
Recorders office where contract is recorded Record number Page
County
Parcel number
Township
description
Is
Real properg— ❑ Mobile Home (IC 6.1.1 -7)
tarry residential structure or the land not exceeding one (t) acre that immediately surrounds Iha re is used to produce Income, describe the use and portion
of tha props 'fired to produce income.
46 Cy�
PROPERTY OWNED BY
•
County Township
County Township
1 hereby certify the above statements are true, correct and complete.
Sign r of daimaA - AJ
(number and sheet cib: state. end LP code)
Ws
Y / V
ASSESSOR •
•
_ pay 20 — 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
• .s
NON-RESIDENTIAL
$
or 43,000 for 2009 pay 2010 40,000 payable after 2012
AT 100% C
Signature olAuditor
VALUE-
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
- - -
Other land
(2)
`. :,: •y _. +
Total lard (line 1 plus lure 2)
(3)
Residential improvements or Annually
Dwelling
(4)
-
Assessed Mobile I Manufactured Home
-. _ -�
Garage
(5)
_
-
Other improvements
(6)
- `` �'.•.
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus lure 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed (month. day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day, year)
r • • r r s •
•
_ pay 20 — 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 112 44,000 for 2008
Homestead Valuation pay 2009 41,000 for 2011 pay 2012
$
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature olAuditor
Date signed (month, day. yW
i