Homestead_Gatton STATE FORM 53569(R215-09) TREASURER FORM TS-IAI
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-i.l-22-e.l
_IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
dP uction 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
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. .
PAR I: PROPERTYINFORATION • .
Taxoaver Name Property Address State Parcel Number Leal Description:
Dennis D/Ginny M Gatton RI Box 172 26-20-02-300-000.025-001 001-00025-00 PT SE SW 2-3-9
Oakland City IN 47660 15.654 AC D-8
Complete and return to: /
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2:TAXPAYER INFORMATION
owne:L9 First jr) Middle Last
Mailing Address(minter and street city,slate and ZIP code) /;
9786 6 S�6 \ 07)K 4kTh Same as;needy aaeress 46
.
Spouse First Middle Last
Vz-RGLN1--4 He CoR, x - - GA; 1"
Mailing Address(nurrber and street.dry,state and ZIP code) / Same as propy address -
. s4 ert .
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 rl{ax be liable fory6'aQk taxes and substantial financial penalties.
1 Si Lure Date /77,
PART 4: ADDITIONAL INFORMATION
• 1
tea? +3
as a CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R215-92)
rug
INSTRUCTIONS: See reverse side for filing instructions.
ORM_ YEAR
AT% 6 1994
e) __h�)- J/v_VA.LW :J . 4- t c��•o *— certify that on th�{UM��+I�en; lsa�
��) occupied as our principal place of residence the folio ng described real property for which a Homestead Property Tax Credit is hereby claimed
l(We)owned ❑ Are buying under contract
Have 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.
CONTRACT RECORDED
It buying on contract. Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
PROPERTY DE
County
Tow hip
HOMESTEAD
VALUE
inq distri t (c y, tow ,township) -
Parcel number
Legal de n
It 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.
o?C -av -oA -3vo - C)0 . oa s -a 0/
ASSESSOR USE ONLY
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
HOMESTEAD
VALUE
Township
County
Township
Weby certify the above statements are true, correct and complete.
Sign r of almant .
Address r umber gnd street, a
late. ZIP code) 71:9
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
1 (1)
Other land -
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
,
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 jobs line 7)
(S)
1 hereby certify the above is true, correct. and
complete.
Signature of Assessor
I Date signed
- ',ifyirg action - Signature of Auditor
r
Date signed
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or S2,000
STANDARD DEDUCTION
Date sTiV / _