HomeMy WebLinkAboutHomestead_Keown STATE FORM 53569(R3I5-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE 106-1.1-22-8 1
- IMPORTANTtNOTICE TO HOMESTEAD PROPERTY OWNERS r,
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
a-eduction 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 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.
PART!:'PROPERTYINFORMATION„tk r :',., t .;,,.c fir:} .tfpl';3;;,.;;=, ,
Tasoaver Name Property Address State Parcel Number Leeal Description:
Robyn N Keown
104 W WALNUT ST 26-18-13-404-000.775-026 OLD PLAN 22
FT BRANCH IN 47648
•
complete and return to: Iillilliii'iuuGunuuSil(lEui{I1[iif 1iiai11uiiulCuwEV
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
. -� ' 2,a PART.2:TAXPAYER INFORMATION- - . ..., . . ,+ .' .;.z.<
Owner 1 First last
�20134r) N edcur)
Mailing Address(number ar� sireet.city,state and ZIP code)
[vJ ean°as property address
� Last
Mailing Address(number and street,city,state and ZIP code) - j'i Same as property address
Social Seanty Number(last 5 digits) Drivels License/State ID Number(last 5 digits) sole Other(please specify in Pan a below)
-. _ ,'s.t 8-- = e -PARTJ3: CERTIFICATION, 3 ;x ' '4 .18_y,,, ,tte __s� sr`•-. • :.
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 gnature Date
• FILED
: - —
r C. .PINesita--
- - -- - — — - __ _ , _-
GIBSON COUNTY AUCtTOR
4� �*°t CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
'e y State Fwm 5473 (R5 / 10-01) .
Presai6ed by ihe Department oF Local Govemment Finance
INSTRUCTIONS: See reverse side lor liling insfructions. �
?�.,;�`_t" �' i �- - .,-;; _. - . - CERTIFICAl10N S7ATEMENT"�-- �
� (we) d �
I ) occupied as r princip of resi , e following described rea roperty for which a
I(We) owned ❑ Are buying under coniracl
�Have a benefidal interest in the entity that is liable for the property tazes on lhe pmperty and th;
FORM YEAR -I
HC10
of March, 20_
is hereby Gaimed:
'(��daia contract.
,c�,�:,.. , e��o. ' '�-v.�.' - '. , . ..��'.,a.._..CONTRACTRECORDED:.:..�. .....,•:`. ,- ` -.:s�
>::`ir -nr"�,. . t..' _ .-s ci_.- . ..
If 6uying on contrad, Fee Simple ownefs name'
RemNers olfica where contract is recordetl Rewrd number Page
Couny
u sr � �
�Tavnship � '� �..'
Tacing
. _. � i . ��.t"4�. .. .. .
Parcel number Le9 tlescri ti Is the pwperty in Question:
O/ l � � 7 7�� � � ��yy� p2 Z ❑ Real property ❑ MoOilo Homn U.C. 61.7-7)
If any portion ol lhe residential sWClure w the land no� axceeding one (1) aue lhat immediately surrounds lhat sWCture is used lo produce income, desuibe Ihe use antl portion
of Ihe property uUlized to produce inwme.
�-�'�-�� 4��� �� �"� � - ''� -� TRUE-TAX � �ASSESSEU VALUE �� HONIESTEAD � �� J NON-RESIDENTIAL � "�
��fi�t;�� SSESSOR USE,(ONLY �, _�.r � �`- y� VALUE:_ .�: �AT t00Yo OF TN `� VALUE .:' �-f`-� 1 �:r_VAI.UEF�_,^'?�ap %�.�
: ._ . . �. - _ . _ ...,. . . „ ... . . ... . _ . � .
Land not exceeding 1(one) acre immedialely ' z.,�i�'v3�'s }� "�� ?..(
surrounding residenGal improvements (�) - ��r� .�:}.• •1;?-`.�z�'.
Other land (2) '" � �+r. -s y. '
.'->.i=?,•;. _,. ._,
Tqal land (line 1 plus line 2) (3�
Dwelling (4) �,j � � +��'°� ��r� � +.�`r � ;
Residential improvements T . �"�-' F
fi�
Garage (5) ����Faxty_��°,;"��.��4.��,.�,
:i{'�.Ti.;�,F��F,n._ _ �"s..-:
Otherimprovements (6) � �; �S4s0
�-V
Ttlal improvemenis (line 4 fhrough line 6) (7�
TUaI value (line 3 phs line n (g)
1 hereby ceAify the above is We, cortecl, and Signawre ofassessor Date signed
complete.
Vaifyirg action - Si9nature ofAuditor Date signed
20_Pay20_
Lesser of tY2 Homestead
Valualion or 56,000
otAud"nor
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