HomeMy WebLinkAboutHomestead_Buehner STATE FORM 53569(R3A-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2.009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1 22-5.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS " ' T'
'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
"'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.
a :. : • PARTI-PROPERTYINFORMATION
Tasnaver Name Property Address State Parcel Number Leval Description:
Kenneth R Buehner 6465 S 700 E 26-20-17-100-000553-001 PT N\V 17-3-9 .38 AC
FT BRANCH IN 47648
Complete and return to: IIDIIDII II IDIDIQQ[I11IIDIII]II31IHII'I11lICIII:I10101I1111111
. C!NSON COUNTY AUDITOR, :41 N MAIN PRINCE-T.0N IN$7670 -_ _ -
PART 2: TAXPAYER INFORMATION 1 4:7474;:t,
Owner 1 First Middle Last
r-Nl a- n Le_ Ly t, h `3 v-e..v n �-
Madmg Address(number and street.city,state and ZIP cede)
I 1Saame as property address
62 y 1.125— S A y O O �c�-L [JAlk^ G` 7--^1 7/a `It
,
/.
spouse First Middle . Last
ken n e.._ P.Ji,y c ki-e_••I-‘)neyr-
Mail g Address(number and street,city,state and ZIP code) 11 . Same as property address
r::-... - :a.`: r' _. ;:PART 3: CERTIFICATION : „„`• • ..7411,-,_ r ),-.- r.
=cob.i.dercigned ccrtifes under perouy cf psr',r:..,thatthe-above:rid hie-cl%,information is true _rd-correct.and that.he Or she 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
Ln.:�.: ya` ,a.. ... :: "a va,�A '`. ' y .+.�:;.'PART 4 A DD. ITIONAL.- NFORMATOV u-„- t`r.tl X.x.(��:v 4w t.‘ {'. I
• FILED :t_
FEB 0 6 2013
-
GIBSON COUNTY AUDITOR
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fonn 5473 (R715-M
Presorted by the Department of Loral 0overnment Ftnance
INSTRUCTIONS: See reverse side for filing instructions.
FORM
HC10
F I L EID"
CERnFlCA-noNSTATEMENT"
I (we) r" at on the 1 at day of March, 20_
I (We) ooctjF4d as our principal place of residence the fbl#ng described real read Pro�lis:hereby claimed:
I (we) owned ❑ Are buying under contract
GIB ON COUNTY AUDITOR
slave 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
W.',k4r 5W9- CONTRACTRIECORDIEDU-fK-T,, `Q
If tx v on contract. Fee Simple owneft name
Recorder% Glace where Contract is racaded Record number Page
%-.'�-,�Z�PROPIERTYOWKEO 8Y,'CLAJMANT,,IN
Canty
Township
TlacirmdiArict cify town, townsfxe)
I Vno--(�vC d -�
Parcel number
Legal description Is the property in question:
f
I ❑ Real pruperty ❑ M.W. Hrne (I.C. 61.1-7)
If arty poftion of the residential stixture m the lantl not exceeding one (1) am that immediately surounds that structure is used to produce income. describe the use and portion
of the Irly util;ted to Produce incorne.
d,& - ozO- /7 -!DO- 000,5.53 -ODD
%-.'�-,�Z�PROPIERTYOWKEO 8Y,'CLAJMANT,,IN
County 77717ns
hip
County
Township
I hereby certify the above statements are true, correct and complete.
tui of of
a =Az
A&= ( number and 3frW4 ary, state, BP code)
5. r711(1 191-,_T(
E-- an0u AZI716�19
N,�I�
�,.TRUErTAX 4
'ASS ESSEDYALUE
R
�NON*WSIDIENTU
Vduation or S35.000
$
SignaLwe of Auchar
Date signed
n
Land not exceeding I (one) am immediately
surrounding residential improvements.
Other land
F/
Total land (Ane I plus Ere 2)
(3)
Dwelling
(4)
7_
.215�
Residential improvements or Annually
-
Assessed Mobile Manufactured Home
Garage
(5)
.
kg..'X.
'r IN
M
Other improvements
(6)
Tdal improvements (fare 4 through line 6)
(7)
07
Total value (lure 3 plus kno 7)
(8)
1 hereby certify the above is true, correct, and
SignatureafAssessor
Date signed
complete.
Verifying action - Sagnabare of Auditor
Date signed
20_ Pay 20_
Lesser of 12 Homestead
Vduation or S35.000
$
SignaLwe of Auchar
Date signed