HomeMy WebLinkAboutHomestead_Gardner r
SIAM FORM 5174.11CI,.MI EAEALnint FORM TS-1A
APrnm'ED BY STATE BOARD OF AMENTn.Yrr, PtIJBM BY TIM DEPARTMENT OF LOCAL wvatsslrrT FINANCE IC 4-1.1-ral
0 'County Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sundani deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than e'er for homestead fraud.Ilomestead fraud causes higher tat bills for all:therefore.
'i HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to recene the
I I L L D benefit and to provide additional identifying information ices
mation n ur to allow county government to better monitor homestead
i filings.This information will be kept confidential and can only he accessed by authorized county officials,The Dephnmenl of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
APR 8 LULU Taxpayer Name Property Address
_ Gardner, Connie J
— 77/0`e 4/ 5085 S 800 6
GIBSON COUNTY AUDITOR Francisco IN 47649
8503
Connie J Gardner
5085 S 800 E State Parcel Number Legal Description
Francisco IN 47649-9126
26-20-04-300-000.126-001 001-00126-00 PT SW 4397798 AC
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PART 2:TAXPAYER INFORMATION
Cr I f� First Middle Last
�t\\1\€ :c. G 12,IL SO ����yyy )0 e12-
ill Address(numbs and sates,city,state,and ZIP code) -- -- -- - - -Same Is property hadtess -- - . '--
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) 0 Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Sole
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
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
• r I Signature 6-1.1.11.--i Date
J
P ex Gad Oy State Raa'd of ia. Centmtsstonms
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19
SEE BACK FOR FILING INSTRUCTIONS �/00 / —O O /,ZG —00
I, (We) 1 .1.21V1 w �.�CA,IOUV`fL� certify that on the 1st day of
March, 19�, I, (We) occupied as our principal place of residence the following described real property for
l(Wch a Homestead Property Tax Credit is hereby being claimed: 2
I, e) El owned (.
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in County Township
Taxing District (City, Town, Township): wL7Y�
Parcel Number or legal description shown on tax statement:
If buying on contract: Owners name tree simple o. ne0
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
I hereby certify the above statement is true, correct and complete
R4, 1 sk
Addmss
47t,
State 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.
Assessed Homestead
Valuatinn Valuatinn
Dan•
Date:
FOR ASSESSOR'S
USE ONLY -
True Cash
Value
Land not exceeding 1 (one)
acre immediately
surrounding residential improvements
(1)
Other Land
(2)
Total Land
(3)
Residential Improvements
Dwelling
(a)
Garage
(5)
Total
(6)
Other Improvements
(7)
Total Improvements Line
(6) plus (7) equals (8)
(8)
I hereby certify the above
is true. correct, and
complete.
Sig,u�l Assessor
-
ACTION BY AUDITOR -
/V1
JJ-
Approved
—O—U46.A�--Ao
Assessed Homestead
Valuatinn Valuatinn
Dan•
Date: