HomeMy WebLinkAboutHomestead_AnslingerFORM YEAR
HC10
I l'A � P!
certify
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o u d as our Principal p of residence the following described real property for which a stead
'Pal p of (We) )
(W :U,4:d, p
s 0�
�X(We) o nead E�] Are buying under contract
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns th4
that
list ) day p0zh.20
I —
Credit i by claimed:
1.7
'CONTRACT! RECORDED
If buying on contrad. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
-PROPERTY DESCRIPTION
County
Township
Coun ty Township
Taxing district P
I Zo ) wn, —s A1,10
Parcel number
pli
05
AT,199%01FTTV'
Is the property ion;
L_P'Real property ❑ Mobile Home (I.C. 61.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediatety surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
QS2 qajc�
surrounding residential improvements.
- ,'•PROPEkTY OWNED BY CLAIMANT IN OTHER-CCiUNTIES"�"�','-":!-,, t',
County
Township
Coun ty Township
I hereby certify the above statements are true, correct and complete.
S1, o laimant
-
'dress (number and street, city. state, ZIP code) ( ) V
'jtj-r STANDARD. DEDUCTION ALLOWANCE'
20 Pay 20
Lesser of 112 Homestead
Valuation or $6,000
Signature of Auditor I Date signed
.7
.TRUE2TAX
ASSESSEDYALUE
&:HOi1IitiTA6!
Z%k-N00iESIDENTIAi:91k-,
ASSESSOR ,USE ONLW_ ,L-
'VALUE
AT,199%01FTTV'
'-`VALUEIC� �
.VALUE'
Land not exceeding I (one) acre immediately
surrounding residential improvements.
Otherland
(2)
4]t
Total land (fine 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
gp-
Garage
(5)
U
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
'jtj-r STANDARD. DEDUCTION ALLOWANCE'
20 Pay 20
Lesser of 112 Homestead
Valuation or $6,000
Signature of Auditor I Date signed
STATE FORM 53569(R3B-10) - TREASURER FORM TS.IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.IS2-3.I
Q' IMP OR ,A44TI�N�0�7ICE�T�O�HOMES:TiEaAD�P.R'OPrE'RtTnY ®,W.'INEdRS
aRi�ls. '�re�i 1 gsrs�al� ���_
individuals and married couples are limited to one homestead standard deduction. As the receipt of this
.,ion 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.
f� r ->..>/s, PART I: -PROPERTY INFORMATION r._, ss
Taxpayer Same Property Address State Parcel Number Leeal Description:
Jennifer E Anslinger 5697 N OLD HWY 41 26-04-12-400-000.629-018 PT SE 12-I-I 12 AC
HAZLETON IN 47640
Complete and return to: I®IIOi)lmmMIDEmDm II m��m�mQUUUm®
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
v< r 24. I7ARTS3 TAXPAYER,IN FORM A,TION - _ - _ .
Owner 1 First Middle Last
Mailing Address(number ands et,city.state and ZIP code) / ��
I Same as property address
Spouse First Middle Last
Mating Address(number and=eel.ply,state and ZIP code) Same as property address
•
Social Seasity Number(last 5 digits) Onvet's License/State ID Number(last 5 digits) sate Other(please specify in Pen a below)
:mss r ,.__: �.. _ -�n.�r5 �,-,.:a;� :> -•.P:4RT, CER. IFICA' ION-_ -a ;>:: - -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.
er 1 Signal Date
- ' ADDI
; ✓. rYf PART 4:sTIOiw.iNFORNIt TION: ;(
Ys Ya.. _
FILED
NOV 20 2012
L,ItbSUN COUNTY AUDITOR
- o