HomeMy WebLinkAboutHomestead_Davis (4) STATE FORM 53569(R3/5-10) TREASURER 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 TOHOMESTEAD P.ROPERTY',OWNErRS
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
uses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
s dard 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: PROPER Y e'FOR�11Tt0\
Taxpayer Name Property Address State Parcel Number Legal Description:
Daniel D Davis 202 E COAL MINE RD 264949-103-000.175-026 LOWES ADD 11/12
FORT BRANCH IN 47648 p �nlf If1I p mff
Complete and return to: IIIIII0[11[II111111lUI�IuIf➢m I6II(IIC��[1I1fi® con®
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON DI 47670
•
PART 21.TAXPAYER-I%FORMATION , ,
Owner`16'\\n - , X'n/ First toddle - , — Last
Mailing Address(nunter and steel city,state and ZIP code)
j 1 Same as property address
7,e First Middle Last '
illdyAibaN)S /L+ ay; S
Mating Address(nunter and steel city,state and ZIP code) r —
Same as property address
�v7 F dd../
r
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.
Signature
1 e Date
PART 4::ADDITIONAI: 1\FORMATION i • - _ -
e FILED
_ OCT 2 5 2G2
c. (X�
'3.)YLvy 1J�
GIBSON COUNTY V *N7 gUpj70R
CU0.169 FOl2 HOAAESTEAD PROPERTY TAX
CREDR/STANDARD DEDUCTIOId
smce rv� s�r3 (R� i 5-a�
Pra�bed by Ihe DapeNrient d Lool Govermerrt Fnm�m
INSTRUC710NS: See ieverse side Gx filing instructinns.
Fo�
HC10
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- � ` , - . . . . � � � CHtT1F7CA710N IEYFM: � ' -�� [ .: . -
. _.. . _ . _.... ... .. . __ . . .._ . _- , . . . .. _,....
�(M�e) � , certiTy that on the 1 st dey of March, 2(1_
I(We) ocapied as aa pr'vidpal of the toAOwirg descnbed real poperly far whirh a Hanestead Property Tmc Credt is hereby daimad:
I(We) owned ❑ Me buy'vg under mntrad
Have a benefiaa� mmre,st in me ensry mac is �iade ror u,e poperty ta�ces m me popelty ana mat owns me propeny «is wymg u�er a conaacc
'q��.� � ' � � '- CON7RACTaf�CORDm; �;.' �';:�.'r . s'-?f�si �. '��"y�� ''�ti
tF dry'vg om m�tracl. Fee Sirt�le arrefs reme
F�mdels a16m rhae mWaa is �ecarded Re�d numhm Pepe
. "..,..' '�,` .:... ....... . . . .. . ..."_:• ^ ._'. _PROPERTYDESCRIPTION � ."� ,��: .. .••.. " �'i:�. :'±;. r�
i � ��
Cnmy Tmalup T' d' � . tww�,ddp) ,
' �.
Pa�cel naMa � L �ptim la the cn queffion'
� � P�Y ❑ Mobik Hrnie (LC. 61.1-n �
X anY Voreo� o/the resde�lial �ae w the lad na1 eceedirg one (1) aoa Nat mmedaldy wnwr� tlmi stuchae is used b Woduoe "ekvrtie. dea+be Iha ue and portion
d fhe popetly Wil�A m proMra u�mne.
al�-��-�q- �a3- oob.i-� 5-�a�
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�'. • �" .. :�,ti 'Y�'.::':�PROPFRTYOWNED��BY$LA�lANTOi�OTHERCOUNi1F.S tJ ��.". " n.i1x.�Y.' „5..r:�n.".`.i-:iM1;�4,:
Counry Twnship County Tommchip
I hereby tertify the ebwe SfaEen�enfs are We, cared and cortqleEe. ��+re d daimarq
(nurbs m�d ffieist aA: �m. IlPcode)
..� � " . . . - �� �" t. 7fM1E TAX ASSESSED VALUE F�SiEAD �. NONRESIDDi71AL�'''�v{"
� `,. . �. r.ASSESSOR USE ONLY "- ' �. % ' . . V/LLUE;; �. '�AT,100iL OF TTV . , � ., � VALUE t s ��` �4. r a, w�; �:VALUE y.. �i'*�.4"y����
. {i�::h y�
_ , . .-„ � I '.'r/.� ... r. . .. ��� � .. . . .. ..:.I •
Lmid not e�ng t(aie) aQe �mnedetely �T ;�'. ��l/..r �.- ','��'�{�?,
5�8fwnd'ng 2sidei�hal imp�oYerr�erlt4. (�� ��e ru �� J ff;r o�n'�"�m' l]�,ti�..J'`t�A:
�;�,, •:r r...i .
QI�1� �8/1d �2� `°.� f �. >C', �,' a,
Td� lard (fine 1 pkrslare � i31
ri rr
� ts4Kt'� � t 4 'h� y(l't4
Resdential"vnprvvc�rnentsorMrwaly ��� (4> >,.`�:'���:'i�i'":'i.:��.�.k3�':,'"��Y,�e.,+�:�
A45es5ed Alobae / Maratfa�red Hartie � �, p+",%1`,•�+ ay� P�,�', ��rc��i fis
yn�1K�y.
�e �5� Si.i�_,�Y�.tO��. �?�f�Y3.�f^:Yw
�ICfQfIpOVOlfI0f1�5 �s� I� . .-� l.y(=5
�. -:c
Tdal unprovert�ertls (�re 4 tivo� 6ne 6) (�
Ti�l value (I"are 3 pds 6ne n (g)
I hereby cer6fy Ihe above is We. carted� anO 59�� ofAS�ssar Data signetl
�p�te.
1�iryvg e�4on - Si�mEae of Audtv Date ag�ed
- � . � , STANDARD DEDUCTION ALLOWANCE ' r' '•., t} r , � •. �:i "� .p �%s SN::T�i'd; x
20_Pay20_
lesser of 72 HorteSrad
Valuatian or 535,000
E
Si�ua of N+d�lv Dat° ^ C
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