HomeMy WebLinkAboutHomestead_Folsom STVE 1 ORM 5.1,t.OC/•.l TRLASOPPA FORM TS-IA
APPMwt',BYR\TL BIMRD Of AECYyc'rt.:AM PlnSAIBrD BY PIE DEPARTMENT OF LOCAL GOVERNMENT FRANCE M41.1-r-r.l
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sandanl deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than nee for homestead fraud.homestead fraud causes higher tat bills for all:therefore.
HEA 1344-1IX9 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 he kepi confidential and can only he 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 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Folsom, Sherri
902 S Main
Fort Branch IN 47648
2623 •
Sherri Folsom
902 S Main St State Parcel Number Legal Description
FORT BRANCH IN 47648-1732
i l l l l I I I I I I I.1 1 1 1'1 1 l'I r l r r r t l l l l t l l l l l l r r.I .1 1 1 1 1 1'l l l I I t t l 26-18-24-204-000.783-026 011-00783-00 LEGRANGE ADD 300PT
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER-INFORMATION
Owner I First Middle Last
JhCNrr\ i=IIen \'0\ 30VY\
•ig Address(number and street,city,state,and ZIP code) Same as property address
q o a 3 . r m, V s4 . Ft, 'a ranch a Lki t.R (I r
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number past 5 digits) Other(please specify in Part 4 below)
- ___ _ sax
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 Signature Date
•
� � CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Slale Fwm 5473 (R6 / {-03)
Prescribed by �he Departmenl of Local Govemment Finance
INSTRUCTIONS: See reverse side /or filing insfmc(ions.
��J "FO� � YEAR
� � �,� � �
APR 22 2U04
� M�e) �Gd�� �C�VI/�J �(,%L+L�.E�Wr� ceitif'y�that on�tlie 1sl day of March, 20_
I(We) occupied as our principal place of residence the (ollowing described real property for which a Homestead Property Tac Credit is hereby daimed:
❑ I(We) owned ❑ Are buying under wnlract
' Have a benefidal interest in Ne entlty that is liable for the property taxes on Ihe property and that owns lhe properry or is buying under a conVaU.
If Duying on canVaq. Fee Simple ownefs name
conVaq is reoorded
County Toxnship
j�e� r O /7�� Legal
L% 0
If any portion of Ne resiEential sWCture w Ihe land not
W the 7roP�N utilizeA b produce inmme.
Iha� immetlialety
Record number � Page
disVict (ciry, town, township)
property in quesUon:
❑ Real property ❑ Nbbile Homo (/.C. 61.7-�
Ihat sWCNre is used b produce inmme, tlesaibe the uu antl portbn
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s+F. ,�4C"'_'='`� ��,.^��§a��, '°P�f-..�_�.ac.�ii �.'�'��--r-�,STlW�ARU'.OEDUCTIONALLOWANCE;tjx'.^`P.���'a�eua.�+—x?:�:Sy'.`�i�t"£.-N°.s.7�`"�:�.'.r'.'icE:���`s+`��'
. _ .... .. .. _ _.. .
20_Pay20_
Lesserof 1/2 Homestead S
vauanon a E35.p00
Sgnatureof/Wddw D tesigned
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