HomeMy WebLinkAboutHomestead_Kleeman STATE FORM 53569(R3l&10) TREASURER FORM TS-IA
APPROVED By STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.1 22-t.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS '' Y
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
doduction 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.
r A '• "' - - - PAR I: PROPER INFORMA' ION ' -• ' r- W rh> '';-:r I •"-
TamarerName Prot/env Address State Parcel Number Eerie!Description:
Stephen 1 Kleeman 308 S EASTVIEW DR 26-19-19-102-000.317-026 PT NW 19-3-10.52 AC
FORT BRANCH IN 47648
Complete and return to: I11fiII0011101I1 DllODIIGIUIIIHII➢ff66ODII11IDll1UII�
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 d W
PART 2i TAXPAYER INFORMATION
Owner 1 Fast Middle \ Last
I �EQALla - � J GSE �IA f, LEE IA n4
Ma ing Address(number and street,city,state and ZIP code)
Same as property address
LI D % Z . { -tnituJ c-r. ADP:1 LRfuJr_I•-1, Z,.../ HribLI
—, _
Spouse First Middle Last
Mailing Address(camber and street,city.state and ZIP code) I I Same as property address
•
Social Seventy Number(last 5 digits) Drivers License/State ID Number(last 5 digits) State Other(please specify in Part 4 below)
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s-r- ,_ , .: ..,. _- j. . , . . .- ..---)PART3;CER IFICATION"` :•-i". . ,•..`; k_.1-.`>::_ `s.,..._.:=.,�•M`'�,
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.
/�Owwnneer 1 Signature Oats
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GIBSON COUNT AUDITOR
CLAIM FOR HOMESTEAD PROPERTY T FORM YEAR
CREDIT/STANDARD DEDUCTION � �j � HCto
` State Fortn 5473 (R817-07)
/
Prescnbed by �hB Depar4nerrt af Laal Govemment Finance
DEC 1 7 2008
INS7RUCTIONS: See raverse side Por filing insLUCtlons. �
COUNTY AUDITOR
� M�e) ___ certity that on the 1 st day of March, 20_
I(We) oocupied as our pri "pal place of residence the foibwing desuibed real property for which a Homestead Property Tac Credil is hereby daimed:
I(We) owned ❑ Are buying under wntrad
Have a benefidal interest in Ne entity that is IiaWe for the property taues on the property and ihat rnms the property or is buying under a contrad.
If buying on contrac4 Fee Simple ownefa rmme
Recordefa
Counry Tamship Tadng districl (c4y, town,
el nu Iber_ '� Legal d85cription ( �g �a proper{y
tf airy porUOn of Ure residerrtial sWGUre w Ne land nd exc�rg orre (1) acra ihat imm�ately wnvuntls f7a1 sW
af ihe property uliGZetl to produce incpne.
Record number � Paga
in queslion:
al property ❑ Mobile Fbme (/C &7.7-n
is usetl m pmduce 6wome, desaibe the use aM portbn
�_ � � � .� • �
� � . �
Land not exceedrg 7(one) aae immediately �) ,3 `�r't�,�.H,-i�, L i�':: � -
surrounding residential improvemenfs. � ��
,a�->__ <_:'.
�.„Li��- yF�j.: y
�i�lEf �3fld 4,.• .
S
(2) : .,"-,3-_�..' :�
TUaI WrM (line 1 plus I'u�e 2) (g�
z`^es'c'3r r:;..� F- �� : � _
Residenfial "unprovements or Mnually Dwe0i�9 (4) :, � ->?"� "*�. ;s-�; .t.,_ K �`
� .,.. �
Assessed Mobile I Manufa�red Home i�t"3�'�Y.`-r '', f�-'` :n �-
Gara9e 5 �-�',� � t -o � �:'� .
( ) �. ss � ,
; r-�
omer improvements (s) _ _ _
Tctal improvements (line 4 tlirough line 6) (7�
Tdal velue (line 3 phs lirre n (8)
I hErBby CBr6fy tlle ebove is We, cortect, aM SignaWre of Pssessa Dale signed (monUr. aay, yea�
comp�ele.
ve;ry�� aao� - sg�awre ota,ai� oa�e s��ed (�„�r�, ear. r�)
2(1— PaY Z� — 45,000 for 2007 pay 2008 42.000 for 2010 pay 2071
Lesser of 12 qq.ppp for 2008
Homestead Valuation PaY Z009 41.000 for 2071 pay 2012 $
w 43,D00 for 2009 pay 2010 40,000 payable afler 2012