HomeMy WebLinkAboutHomestead_Barrett (4) STATE FORM 53569(R3/S-10)
TRFINANE0.FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1-22-8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
auction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
Wcauses 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 eliminat•
homestead fraud.
PARTI PROPERTY INFORMATION T .,
Taspaser Name Property Address State Parcel Number Legal Description:
Donald Kent/Pamela Sue 907 S MAIN ST 26-18-24-204"000.963-026 LAGRANGE ADD 306PT/307PT
Barren FT BRANCH IN 47648
complete and return to: iulMEMuMEjrt7UIRE3iGJJ:1LiHoRJU7i➢liil •
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
• PART2: TAXPAYER INFORMATION ."
Owner I First Middle Last
DehiA Lb 'kaNt eAA K e
Mailing Address(number and street,city,state and ZIP code) Same as propeM address
•
`l07 So u'I'h . 4jW STet6EC Ft5' r f461/
-•_
Spouse First Middle Last
FAni e i-A Sci e ,EAR R et?
Mailing Address(number and street,city,state and ZIP code) I v/i Same as property address
90 7 ft/4T/r Mil;4' nit (-LC 7- Fe /d7 JiR4 f c f, r,s'. N 7. Y6
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 Date
•
�a^�R
a/°'" g CLAIM FOR HOMESTEAD PROPERTY TAX
a��''� CREDIT/STANDARD DEDUCTION
�,;;� Stare Form 5�73 (fl2 / 5-92)
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INSTRUCTIONS: See �everse side 7or liling instmctions.
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�We1�� J�!( `�q�v,J� {. vU,�vr➢.X0. pD_�l.iJ �CL,(jJ�J.n �certifythaP'9�S'tfiA�U'����M.19�4
te) occupied as our principal place of residence the following described�reafproperty for which a Homestead Property Ta�c Credii is hereby daimed
n (We) owned ❑ Are buying under contract
❑ Have a beneficial imerest in the entity that is liable for the property taxes on ihe property and that owns the property or is buying under a coniract.
- � CONTRACTRECORDED� -� � - -
II buying on contract, Fee Simple owner's name � �� � . .
Recortler's oNice where contract is recordetl Recortl number Page
County
DESCRIPTION
� Taxinq dstriy( (
Par�numberOQ� � - �Lega descnpt o ' / \ �, � �C I � / �� � 12
�1 11 3 ,Qi.Ft4 \ �ldC1 `� v �
It any poruon of Ihe residential strucNre or Ne IaM not exceedirg e(1) a that immediately surrounds that structur is used to praduce income, descri6e the use and porlion
ot Ne pmpeny uulized ro protluce income. '
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES � -
Counry ^- Township Caunry � Township �-
certify the above s[atemenis are true, correct and complete. I�9namrp ot ciaim � �
/
Addressq (number antl sfreet. city, state. ZIP co�dje�)
\ L � 7 �i. �iiisc �// _ %'
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ASSESSOR USE ONLY TFiUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE _ VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvemenis. (�)
Otherland (2)
Total land (line 7 plus line 2� (3�
Dwelling (4) �
Resideniial improvemenis
. Garage (g)
Oiherimprovements (6)
Total improvements (line 4 through line � ��)
Total value (line 3 pUs line � (g)
I hereby certify ihe above is ime, correct, and Signamre of Asseswr Date signetl
complete.
r�rityirg action - Signature ot Auditor Date signed
f�: