HomeMy WebLinkAboutHomestead_Folsom (5) cram FORM 53569(KM 3101 TnrsSCRER FORM ls-tA
APPROVED BY STATE BOARD OF ACCOU.NTS.344 PRESCRIBED BY THE OEPARTMEII OF LOCALCOVERNMENr FINANCE IC6-1.1-114.1
Gibson County Auditor INIPORTA! T NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N.Main Street Individuals and married couples are limited to one homestead Standard deduction.As the receipt of this deduction becomes
Princeton, IN 47670 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
li_ FILED benefit and to provide additional iden tifying information necessary to allow county govenlmenl to better monitor homestead
filings.This information will ba 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 1: PROPERTY INFORMATION
APR 19.2011
= Taxpayer Name Location Address
C. .KVy Folsom, Steven
� V 102 N Main
GIBSON COUNTY AUDITOR
Fort Branch IN 47648
7048
- Steven Folsom . II-I(VIII_�IIIIII19Dlii1�111_�II0111111 II �II�IIIII MIDI IIIICI IIfillILI-Ills II
102 N Main
FORT BRANCH IN 47648-1302
IIIIII'II' 'II '�Iilllll"�Illil""II"I�il�l'llllllll"II��'I State Parcel Number Legal Description
I'
26-18-13-404-000.758-026/ OLD PLAN 36PT137PT
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.
— 1 --.. -.-------------,�CART?:TAX PAl_ER INF.ORJ1ATl0\---- ... --
-
Os . I First Middle Last —:
Mailing Address(number and street,city,state,and ZIP code) CEI Same as property address
r1 3f% zN/). v�� ��
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) - O Same as property address
/10
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
II I I I I I I
• 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
CREDR/STANDARD DEDUCTION
Stete Fortn 5t73 (R614-03)
Rescibed by tlro DeparNfeM d Locel Govanment Finance
INSTRUCTiONS: See �e�a+e addo br /Yfnp inffiutlions.
FORM ' �YEAR
H �
�
�(WQ) \ \��./ l7lJ�J�� ceAify"tfiaContlte��t day of March. 20_
I(We) occupied as our principal place oi residence Ihe followin described real ro e for which a (�
. 9 p p rty F�ddi�r�Rv TacCredit is hereby daimed:
❑ I(VJe) owned ❑!ve buying under contract � Y A�DITOR
' Have a benefidal interest in ihe enGty that is liable for the property taxes on Ihe property and that owns ihe property or is buying under a conUaG.
If buying om m�tracl, Fee Simple owners name
recorded
Tawnship
7 S O� ��al descriDtion
(rity, IOwn.
the
Record number
Real Droperty ❑ Mobile Homo
Page
N any portion ol the residentlal sWCWre w �he Wnd nm axceeding one (1) arre Nat imrtrediatety wnounds that shucture is used to D��e income. tlesaibe the use and porUon
of Ihe property uL7aed b produce irkome.
�� ^-�4r A SSO�R�� ON Y�'-.__';��� ''`� c TRU NC �g ASSESSED��VALUE ��HOMESTEADY:S t' �NONitESIUENTIAL��x"h
� _-""" `�Xr�'d.��'zL'i�F�9�""'�5�.���?��'��q� $l�i�. eVA1:UE,`�.°'�-�`"�r'� �/1Ts100%TOFIT/� k.'�VAL'UE` . �'��v�.'-#;:�.'' .VALUE.�Sa�
3 - a.r.,. . �....-, -an
Land not exceeding 1(one) aae immediately ;� Z`� s��''."»+� m��r`���'?�
surrounding residentlal improvements. ��) �3 C'�ip+�� n�'�'� � `
�� i.� ��:: ��
Other land (2� ��� �'��
;2: ^��',�'�._ �� . .�'
Tdal land (line 1 plus line 2) (3�
�� `tk t^.;y rn�
Dwellin9 id) ����o4��rc>� .J.��"�
�Residential Improvemenb a MnuaOy .
Aesesaed Mo60e / ManufacWred Home Gara e �;��.-'�*.:s - w��;.-•-_n-f.:�` � c*
9 (5) ,,�: ��; �.'�t3���`'�'C.,
K..�i ^v'• '� a����'�
r_T.-..x�'�S�':naa�.z1.e.�� � ,:vS'
°y>�" , : i
Other improvementr (6) '.}'�-� _�. ,_���
i a�•.''--�'_=? r.r : -�w
Tdal improvements (line 4lhrough line 6) (��
Tdal value (line 3 plia line � �g�
I hereby certify fhe above is We, corred, and Signature otASSessor Date sgned
comptete.
Verilying action - Signature otAuditor Date signed
20_Pay20_
Lesserof 1/2 Homestead
Veluatqn Or 535.000