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HomeMy WebLinkAboutHomestead_Claridge STATE FORM 53569(R315-10) TREASURER FORM TS-IA APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL.GOVERNMENT FINANCE IC6-1.1-22-s.1 -IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS ,• a - Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud 4 auses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead s 0 ndard 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. PART': PROPERTY •'FO'MA ION . Taxpayer Name Property Address State Parcel Number Legal Description: Shelia R Claridge 504 S CENTER ST 26-19-19-101-000.763-026 PRITCHETTS ADD 251 PT FT BRANCH IN 47648 Complete and return to: 01101Io]11]D lm�um®itionn 00mmo® GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 IIWIII WJ PART 2:TAXPAYER INFORMATION .. ' Owner 1 First Middle last Asa ( n C aair Mailing Address(number and street,city.state and ZIP code) Same as property address Marini;Address(number and street,city,state and ZIP code) Same as properly address Social Security Number(last 5 digits) Drives License/State ID Number(last 5 digits) sate Other(pease specify in Part 4 below) - 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. Owner 1 Signature Date PART 4:ADDITIONAL INFORMATION . FILED I JUL 2 6 2012 ultlbUPi uuu,+1 r rub;TCR I� „..,,,, ea i CLAIM FOR HOMESTEAD PROPERTY TAX , ���; CREDIT/STANDARD DEDUCTION �l,�• State Form 5473 (R2 / 5-92) yu . INSTRUCTIONS: See reveise side lor liling instructions. _:�, ;, _ 9 __ _*� • t i {,T ��We) _���LQJ ���/�/LY CSLx� � certif at on t e is da Marc 9 ) occupied as our principal piace o( residence ihe foil ing described real property for which a Homestea ' ed: GIBSC:: ='s ;.'—;• ::;r.iTOR I (We) owned ❑ Are buying under contraci . _ - - � ' ❑ Have a beneticial inierest in the eniity that is liable for the property taxes on the property and that owns the property or is buying under a contract. � . � � -. .. COMRACT RECORDED , � � � - - � It Wying on contrac6Fee Simple owner's name Recordefs ottice where contract is recorded Recortl number Page Counry TownShip Lega� PROPERTY DESCRIPTION rown; If any portion ot the resitlen;ial sWCture or Ne land not exceeding one (7� aae that immediatety wrrounds that swcWre is used to ot ihe property utilized m produce income. PROPERTY OWNED BY CLAIMANT IN OTHEii COUNTIES Caunty Township County �eby certify the above siatements are true, correct and complete. � sign\/amre 7��C Address (num4er antl streef, city, s(ate. ZIP mde) e. l., / %� . Township tlescribe ihe use and portion ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL .VALUE VALUE VALUE . VALUE � Land not exceeding 1(one) acre immediately ' surrounding residential improvements. ��� � Otherland (2) Total land (line 1 plus line Z� (3� � Dwelling (4) ° Resideniial improvements . Garage (5� - Oiher impmvements (6) Total improvemenis (line 4 thiough line � (7) Total value (line 3 p6s line 7) � (g) I hereby certify Ihe above is true, correct, and � Signature oi Assessor Date signetl compiete. �ing action - Signature ot Auditor Date signed L � �� � STANDARD DEDUCTION�ALLOWANCE � ” � 19_Pay79_ Lesser of 7/2 Homestead I Valuation or 52.000 � Sgnature of Audiror Dare signetl — —r� �