HomeMy WebLinkAboutHomestead_Brittngham STATE FORM 53569(R3B-10) a ,TREP':JRER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVE•:NMENT FINANCE IC6-I.I-22-8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY - ''
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
'eduction 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.
' PAR I: PROPS' Y INFORMA ION i n- •- ., ,g.,".
Taspaver Name Property'Address State Parcel Number Leval Description:
Robert E Brittingham 302 S CUMBERLAND ST 26-18-24-202-000.740-026 BERTHA LINTZ 10
FT BRANCH IN 47648
Conzn(oto and return r0: Ali? Ill flpelnl IO 1119 qlt t:g1111Mr ]ul:rT rag
wui�u1UII IIuuIJGm3CnmhtlIJllab tUft;I luu
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
• PART 2: TAXPAYER INFORMATION
t � First V '\/�1 \ Middle ^v- ^ Last
111 P�r�� . h/ V
Mailing Address(meter and street,city,state and ZIP code) Ime as property address
r M iD
R . C IA vuh_Qf k c n d C \- Y-arl In LA.-1( oU 7
Spouse . First Ain 1` ` Last
861,1\i U n r �Y N�t� y1 ca VVv
Mailing Addre (number and street,city,state and ZIP code) I me as property address
I
C AmAA.hii-r-\a,n o \, V 6 c an c.-Ai, 1.VZ U,l1_la i .
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 1 Signature Date
/-)
0
///
V
arty ' '
ea °; CCAIM FOR HOMESTEAD PROPERTY TAX, `-
a��� CREDIT/STANDARD DEDUCTION
� �{� State Form Sa73 (R2 / 5-92)
i �
yu .
INSTRUCTIONS: See reverse side lor /iling insfructions.
� _ .. . ..�..��'....r.......r�
' FORM-
HC10
I(We) ' l./ • � Y`� ceniryahat on tt}�stNay�t �Mgt� �
upi as our principal place of residence ihe o lowing.descnbed real perty for whicha Homestead Property l�ax Credit is her2b�ch
_J I(We) owned ❑ Are buying under contract • - - �AN � 4�99�
❑ Have a beneficial interest in the entiry ihat is liable for the propeny taxes on the property and thai owns ihe prope or is buying under,a cor
i �
. . i,. ..-. -.�.,..�i��
- � � .. � , CONTRACT RECORDED: - � G � i,�, v � • �;'� �_ i, :�r��
If buying on contrect, Fee Suuple owner's name � � ' _
Recorder's oHice where contrect is recorded
PROPERTY
Counry - .
number I Page
Irj� t�j1\ /�J/ /O O�,[t�galdescription . . . \� .
� Uv i Y � WW
portion ot t�e resitlen6al strucmre or the land not exceetling one (t) acre that immetliarety surrountls that structure is used ro produce income, describe Ne use and portion
property utilizetl m protluce income. ,
PROPERTV OWNED BY CLAIMANT IN OTHER�COUNTIES
Counry Township Cqunty
1 Sig at e ot daiman
,by certify the above statements are true, correct and complete.
F�ltlress (number and stree,� ciry, state, ZIP cqQe) � �,, �� , �_ ,
� ASSESSOR USE ONLY
Land not exceeding 7(one) acre immediately
surrounding residential improvements.
Oiherland
Total land (line 7 plus line Z)
Dwelling
Residential improvements
Garage
Oiher improvements
Total improvements (line 4 through line �
Total value (line 3 p�s line �
I hereby cenify ihe above is true, correct, and�
complete.
�!��Nirw action - Sianamre o� Auditor
TRUE7AX
VA�UE
(�) .
(2)
(3)
I41
(5)
(6)
l�)
(el
Sgnature ot Assessor
ASSESSED � HOMESTEAD I. NON-RESIDEN'fIAL
VALUE VALUE VALUE
'
signed
� STANDARD DEDUCTION ALLOWANCE
19_Pay19_
Lesser of tl2 Homestead '
Valuation or 52,000 S
Synature ol Autlitor Date signed
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