HomeMy WebLinkAboutHomestead_Kolb SUES FORM!J.MIR'/s•nl , 17tFATI ER FORM TS-IA
APPROVED BY SLUE bJVDOr•ETAi.ATA.9v PRISOUBED BY nt.DEPARTMENT OF LOCAL GOVERNS,FPAYE lC 41.1-:_-r.t
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 incentne than ever for homestead fraud.Homestead fraud cause higher tax bills for all:therefore.
- • . _ HEA 1344-2009 requires taxpa)crs who receive the homestead standard deduction to verify that they are eligible to recent the
benefit and to provide additional identifying information nemsarr to allow.county'.govemment to better monitor homestead
filings.This information will he kept cnnfdential 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 cutmty officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
j b l Al /V(LLV'
. 4-1,.. 90 A
Patoka IN 47666
2838
State Parcel Number Legal Description
Patoka IN 47666-0146
�t�tt��rtt�t��ttr��ttt��t111 11t1tt1r11ttrht.lt llrtlltrrl 26-04-24-302--0 000.206-020 018-00206-00 COL DIV 26PT/27PT/35PT
Mailing 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) Other(please specify in Part 4 below)
sae
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
PART 4:ADDITIONAL INFORMATION
•
--T
FORM TIC 10 1979 ro Be Filed in Duplicate
Prescribed By State Board at Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 '77
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description
Taxing District (eiiy- Town, Towrts4arp9-
Parcel Number I I t I
If buying on contract: Owners name 000 Simple owners
or legal description shown on tax statement:
Contract recorded in Recorders Office - Record
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
® v 1l o .I
vreer naaress
ury. Jan, no Zip L e
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.
FILED-
- FOR ASSESSOR'S USE ONLY -
True Cash Assessed Homestead
Value Valuation Valuation
Land not exceeding (o cre immediately
surrounding reb lriltilLbir rtoLements
Other Land
Total LX. / AUDITOR
Residential Ir114-ovements Dwelling
Garage
Total.
Other Improvements
0 T�' -t Improvements - Line (6) plus (7) equals (8)
by certify the above is true. correct. and complete.
Signature oL Assessor
- ACTION BY AUDITOR -
• / / /ii % / //�
/OD
I
Dare
Approved: D & Date: