HomeMy WebLinkAboutHomestead_Hasselbrinckr
TREASURER FORM.TS-IA
STATE FORM 5336A(R31&10)
' APPROVED BY STATE RMRO OF ACCOUNTS,TPN PRESCRIBED BY THE UFPARTMECT OF LOCAL GOVFRNME,NT FINANCE M6113181
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street - Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
Princeton,IN 47670 more beneficial,them 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 beuer monitor homestead
�1 T filings.This information will be kept confidential and can only be accessed by help county county officials.elii eliminate The Department eadfra of
Ye{...I, Lr Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFOIL\L4TION
APR 8 2011 Taxpayer Name Location Address
Hasselbrinck, John L II
C.3.rA .�" 711651050W• (�\} v\ OWENSVILLE IN 47665
. GIBSON COUNTY AUDITOR
1 - _ II II II II II II
John L Hasselbrinck IIII IuIIII�uIIlluIuIIIIIIIIIIullll_�IIII�IIIIIII�DII�II.IIII.I�IIII IIII_IIII�IIDII-IIII IIII III
7116S1050W
_ OWENSVILLE IN 47665-9344 State Parcel Number Legal Description
t'IIIIIIIIIIItIIIIIIIIItlliIlliIllllItllItlllhIhIIIIIII'IIIIIIIlI -
26-17-1 6-300-003.767-021 PT w Sw 16 3 12 10.00 AC
a• - - ---- ----- - d D-16-20 _
•
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
(TART 2: TAXPAYER INFORMATION
L.I Fist Middle last ,
Jo1Nn l_ae- /fctsselhr if?ck
Mailing Address(number and street,city,state,and ZIP code) Dame as property address
711 & 50014\ /060 Lksf otoensvi//e, /d 97665
-
Spouse First Middle last
W 0. o•J'(■—1
Mailing Address(Number and meet,city,stare,acrd ZIP code) _ --— - .----- - _-—M.S.-Un-'as prop''It---- - •-- -- _ -
7 !IC 5, / o5o W. Otae,n5v,//e , /A/ `176650
.
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.
Owner I Signature r r Date
PART 4: ADDITIONAL INFORMATION
CLAIM FOR HOMESTEAD PROPERTY TAX
� " CREDIT/STANDARD DEDUCTION
t N» � State Form 5473 (RS / 10-01)
Presaibed by Ure Department d Local Govemment Finance
INSTRUCTIONS: See reverse side /or (ling instructions.
FORM
HC10
�
YEAR
��e) � � V� certify that on tha�y �f MarF/p,�_
I(We) occ ed as our principal place of residence the (ollowing descnbed real property for which a Homestead Property T r it i hereby imed:
❑ I(VJe ed ❑ Are buylrg under contracl . �//` � �/fj�
�Have a benefidal interest in the entity that is liable for ihe properry taxes on the praperry and that owns the prope��rty;or.i5.6ynng under�'a�contrad
If buying on conirad, Fce Simple ownefs name
Recoiders ofice where mMreU is recorGed
County
Tamship
aisuict (ary, town, rownship)
Record number � Page
r�j �i ,n�um h L �tlQ� � � Is the property in question:
tiCJ — V 31b%-Q7 �u�tiJ�l.lT% 6'.3'{0�. ❑ aw o.oaenr ❑�.wwia H«�o o.c. o-,.,•n -
N any ponbn W Ne residential atrucwre w me land nd exceediip me (1 J ava mat imm��y �lpynds thet swcwre is usee W produce income, desaibe Ne use and pwtbn
ot the P�P�Y ulifaed tn produce ifrcome. / V 7 �`.
- / / �//n � �f//// —
20_Pay20_
Lesser of 1/2 Homestead
Valuation or $6,000
Sig�aWre
$
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