HomeMy WebLinkAboutHomestead_Dilbeck (2) STATE FORM`�W IR'/!-nl TREASURER FORM TS-IA
1PPPItED BYSr1TE M1PD Of ACCOUNTS R'ry ParYAfatn BY ntr OEP.1nflENt OF LOCLLCYJER.VMEAT EA'A\CE re.-it-r-a.t
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
air more beneficial,there is more incentive than ors-for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
III HEA 1344-2000 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reecho the
benefit and to provide additional identifying information necesan to allow county government to better monitor homestead
tiling..This inlumuunn will he kepi confidential and can only he accessed by authorized county officials.The Depanntent of
Local Government Finance sy ill use this information to create tools that will help county officials eliminate homestead (mud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Dilbeck, Richard A/Donna F
400 N Eastview
Fort Branch IN 47648
7694
Richard A/Donna F Dilbeck
400 N Eastview State Parcel Number Legal Description
Fort Branch IN 47648-9704
11111111111111.111.1111 lIllIIHLrlIlL1111I III11111 III 26-19-18-302-000.485-026 _ 011-00435-0OHILLCREST75PT
PART 2:TAXPAYER INFORMATION
Owner I First Middle z Last
i
lii6ti /-A _ _ALL E A _ �yD / 1. -
�g Address(number and street.city,state,and ZIP code) ,l/l Same as property addles; — --
Spouse Al 1 • First _ 1 Middle Last
Mailing Address(Number and street,city,state.and ZIP code) (�V i Same as property address
`__ ..
PART 3 CERTIFICATION "-=—" .- - . - ----1:-:---r--''—,"-"--T---f
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.
Os.ner Signature ` Date
0
�� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Slate Fwm 5473 (RB / 1-03)
Prescribed by ihe Department of Local Govemment Finance
INSTRUCTIONS: See reverse side loi Iiling insfmctions.
FORM
HC10
I (We) i7C � / [/ '�i �//� , �—� �.Cc�-lY / ( �c/ (} �j /i G cecGry tha[on the tst day of
I(We) occupied as our principal place of residence the following descnbed real property for which a Homestead Property T it�
❑ I(We) owned ❑ Are buying under contract ���� �
: Have a benefidal interes� in the enfity that is liable for the property taxes on the property and tliat own pr e Nng ur
If buying on conVad. Fee Simple owners name
Recordefs ofice whaze con4aIX is recorded
Caunty
Parcel n° / Tbe`
H any portion of Ne
ot the orooeM utila
YEAR
20_
daimed:
a wntraU.
Page
Tumship Tating district (ciry,�� tawn
�r a �l f i , �/�-,,/�lE/�
_ Legal descripGon Is ihe property in hon:
�O O � Real D�operry ❑ Mobile Hwno (I.C. 67. f-7)
aWCNre w Ne land nW euceeding ma (1) acre Nat immeAiatety wrrounds ihat swGUre is used b produce incane, desaibe the use antl portbn
�ce income.
Tavnship
I hereby certi(y ihe above statements are W e, corted and complete.
reu n�^ ber and sfreet, ciry, sfafe, 21P code)
�O /U� ,��, sT� �r� N/ f/ ��r, ,t
County
1.
20_Pay20_
Lesser of 1/2 Homestead
�i ��UOn a f35.000 _
$
�i�!- o