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HomeMy WebLinkAboutHomestead_Smith (3) FDA:,"`.°'.° "79 L_ To Be Filed in Duplicate Prescribed By State Board of Tax Commissioners - ■ ✓ CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 Yo f SEE BACK FOR FILING INSTRUCTIONS ® (We) - -iY certify that on the 1st day of March, 19 TO, I, (We) occupied as ur principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby being claimed: I, (We) ❑ owned ❑ are buying under contract ❑ have a beneficial interest in the taxpayer Property Description in County // Township Taxing District (City, Town, Township): �Zd--K1-,t-q Parcel Number or legal description shown on tax statement: If buying on contract: Owners name (fee simple owner) 0°172 ,f-> 9/ /_ O Contract recorded in Recorders Office - Record No. Page 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 Any other counties in which individual owns or is buying real property: County Township ,hereby certify the above statement is true, correct and complete. ire R. R. a, 10 � � y true' ture Street Address kity. Stale and Zip Code • Individual either owns or is buying under a contract that provides he is to pay the property taxes on the residence, or has a beneficial interest in the taxpayer. - FOR ASSESSOR'S USE ONLY - True Cash Assessed Homestead Value Valuation Valuation Land not exceeding 1 (one) acre immediately r surrounding residential i e (1) �Ti'9 4" 7.e - '© Other Land F � II(2) /A hit a Total Land i� (3) / 7 4/ 0 _y///���������� Residential ImprovementMAY ? 1980y_ (4) a 7 6 �o o �f �L � Garage (5) c _ j�: (J[ AUDITOR Total (6) O 7 OD Other Improvements (7) 4. 0 l y ? U 0 Tc' ' Improvements - Line (6) plus (7) equals (8) — (8) 3 ) 9 a•O / U 6, O by certify the above is true. correct. and complete. /5.2012 „, 5--- / O — g0 Si• a of Assessor V Date 41 - ACTION BY AUDITOR - Approved: Date: _STATE FORM 53569(R29-09) TREASURER FORM TS-IAI i API:ROVE DBY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.I-22-8.1 IMPORTANT NOTICE'TO'HOMESTEAD'PROPERTY OWNERS ERS 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 •auses higher tax bills for all; therefore, HEA 1344-2099 requires taxpayers who receive the homestead andard deduction to verify that they are eligible to receive the benefit and to provide additional identifying s g 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.tbat Will help county offiicials.eliminate - . ' homestead fraud. - . PAR 1: PROPER Y ENFORMA •ION . Taxpayer Name Property Address State Parcel Number Leal Description: Lois M Smith 3104 E McRoberts Rd 26-05-57-091-000.722-017 009-00722-00 PT MD 91 1-10 14.22 Patoka IN 47666 .r AC C-I h Complete and return to: _._ - - - _ -- -- GIBSON COUNTY AUDITOR,-101 N MAIN PRINCETON IN 47670- - • — - - "'' PART 2: TAXPAYER INFORMATION . Ovmer I First Middle Last Aors 0a_Y i e Smy. -2-4 Mating Address(number and street,city,state and ZIP code) Xi � Sarre as property address J ( 09- L. ine Qoberts 10, la"l l oWcc La. 0- 7416 . ---- First ' . .Mktldle Last Mailing Address(number and street,ply,state and ZIP code) Same as popery address Social Secunty Number(last 5 digits) Drivels License State ID Number(last 5 digits) Mare Other(please specify in Part 4 below) -_„...„. .., �,.-,_a — ,r _ r__., PART3::CKR_IM)CNT10N,-.c>,-.._ a.,.... tea.. . _ 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�,/,'n/ Date /;-f+— ( ) . - ' PART 4:,ADDITIONAL-INFORMATION • - • •