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Home My WebLink AboutHomestead_Cummins (2) STATE FORM 51569(RE I)-09) TREASURER FORM TS-IA ARAOVFD BY STATE BOARD OF ACCOUNTS.:W9 PRESCRIBED BY T16 DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC641-214 I IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS "'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 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 indentifying 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 I: PROPERTY INFORMATION • Property Address(number and street,city,state,and ZIP code) Z/ V2 M •// 62 (1-if FILED State Parcel Number 076 -/a_jo03_ ono. O/S- 0d6 S�EEPP262013 J ---- GIBSON COUNTY AUDITOR PART 2:TAXPAYER INFORMATION • Owner I First Middle Last ea ks Mailing Address(number and street,city,state,and ZIP code) ❑ Same as property address .so/ • P/ //e Spouse ( First Middle Last Mailing Address lu(Number and street,city,state,and ZIP code) Same as property address 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 I eg6[ure Date .- PART 4:ADDITIONAL INFORMATION • INSTRUCTIONS My P fFL5 CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION Stete Fo`m 5473 (R6 / d-03) PresaibaE by Ne Departrnent of Local Govemment Finance INSTRUCTIONS: See 2verse side lor �ling instn�c8pns. � FORM YEAR HC10 I1LJ�� 0 I(VJe) � Q}(((�/ ��.a.(�.�„ Y'( („�(�(/»'�J�"Y(.(��'►/}+ certify ihat on the 15t day o( March, 20_ I(We) occupied as our principal place of residence the following described real property for which a Homestead Property�3�P�Fgdi(-i5 �by daimed: ❑ I(We) owned ❑ Are buying under contrect GIBSON COUNTY AUDITOR ' Have a benefidal interest in the entity that is liabie for the property laxes on the property and that owns the property or is buying under a contract. If huy'ug om m�Vad. Fee Simple owners name Recordels otfice where contracl is recorded County Toxnship P�ycel numher O� '� Legal cnp FJ� i i/ any portion of the resiAen9al sW qure or the Wnd not axceeding one (1 j arre that af the properry utilizeA to produce inwme. Record number � Page Tating tlis�ritt (rity, fown, township) . I Is ihe property in question: ❑ Real v�oparry ❑ Mabila Hwno (/.C. 6f.7-7) wrrounds that swcfure is used to protluce incame, desaibe the use and portion ��'�; ASSESSOR S ON Y -ii'�� i-+�"TRUE TAXt� -- ASSESSED VALUE �>HOMESTEAO��. � NO�N`-RES��ENTIAL�'�+'�i"� t� �> " e. ...5_'ii . : x s`y"`r:.y' �. _ L.-.: �.4'e�..,3 i-�.c"'•�VALUE.:r,rn.rs .s-��, ,�,AT:�100% OF TTV� ��VALUE� "rz'��i. r��s .-�?�"..'�'e..VALUEI-e�a." i4� Land nol exceeding 1(one) aae immediatety K^,e�'',�z�f�^.�,� ��i� surrounding residential improvements. (� � Y� � t ;�,'`��X�r ^.`Fy T�,.�'_,: O�herland a�`�a��'� � � Z �� .�-..�a� � Tolal land (line 7 plus line 2) (3) �, �,�,�-� ts �s`��.=d�7 Dwelling (4) �c�,��G�� ResidentlalimpmvementsorMnualty � 3;�� ; �� hssessed Mobile / Manufafxured Home Garage (5) ��i��n�� `3 � h'sy~�� qiK '��. L'iy� .'L i� Otherimpmvements (g) ��':�" -� r�*3 .�-i 3:?�Yt:�r�''. Tctal improvements (line 4 through line 6) (�� Tdal value (line 3 pl�s line n (g� I hereby certify ihe above is We, coned, and Signature otassessor oate signed complete. ' Velifying action - Signature oflwtlimr Date signed 20_Pay20_ Lesserot 1�2 Homestead ValuaLOn w 535.000 Signature of Audilw 3 I Date signed� ^ � �� 1.7� �..- w �T� T_ - _