Homestead_Miller (10) STATE FORM 53569W/8-lb) _ TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,22009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1.22-9.I
a IMPORTANT NOTICE TO HOMESTEAD-PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
auction 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.
PARTI PROPERTY INFORMATION '. `
Tatna er Name Pear/ern Address Scale Parcel Number Leal Description:
Kevin D Miller
105 N LINCOLN ST 26-19-18-303-000.912-026 WALTERS ADD 133
FT BRANCH IN 47648
'Complete u::u'return to: illflISIIIIIIIM111111111111.11011101011111111111111,11111i
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
04: * �'. - . PART 2: TAXPAYER INFORMATION „r' : ;ML
Owner 1 First Middle last
v/ n D o- L c. "//e.-1
Mailing Address(number and street,city,state and ZIP code) [ ' Same as property address
Spouse First Male last
Matting Address(number and street,city,state and ZIP code) I I Same as progeny adbrass
Social Security Number(last 5 digits) Driver's License/State ID Number(last 5 digits) State Other(please specify in Part 4 below)
s v. * _ 3, 4PACYIF;A�l�I:il1LiC �l�lp�l 1 ®t oy ne, _tom
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 1 Signature Date
ic,:
DEC 17 2012 //
GIBSON COUNTY AUDITOR
� i
�
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Stata Form S173 (R6 / d-03)
PrescribeE by the Departrnem of loral Govemment Finance
�NSrRUCnoNS: s� �re,sa � �, rir�y �s.
C„R� YEAR
�Lc, � m-�{
�
APR 2 7 2006
�(We) �\ p(�„(yl �� I.0 L 1�0�1 certi ��tFiat oiri�e fst
� f� �lo-jMerch, 20_
I(VJe) occupied as our principal place oi residence the (ollowing descnbed real property for which a Homestead Property Tac Credi� is hereby daimed:
❑ I(We) owned ❑ Are buying under contract
, Have a benefidal interest in the entiry Nat is liable for the property taxes on Ihe property and that mms the property or is buying under a contracl.
If buying om m�uap, Fee Simple awnefs name
Recorders office whera conVaC is recorde0
,+�.^ �a•-s .n%: 'rJ�Yi°,:''��� ..:n.S
�"3�,e��.a.����%�§'r'L;�'S?t'it-��R
CounTy 7avnship
Parcel numhef
�1�-00 `j'/�-
If any poAion of Ne residential sW
or Ihe pioperty utilized to Woduce i
County
Legal
or Ihe Wnd nm exceeding
Tavnship
aua
I hereby certiy the above statements are We, wrtect and compiete.
Addrass (num6eraMSheet city, sfale, Z/PCOde)
Record number � Paga
Tating
I Is Ne properly in queslion:
' ❑ aeai o�oaanr ❑ blablla Homo (I.C. 61. f-))
wrtounds Nat sWCUre is used lo produca income, descnbe Ne use antl portion
County
Twvnship
a��Y` F^3 1�lh � 3.��"i�� p N'Li +y�- �''i' ��"' 1 w-i > '- ! P_ i7 'stcr�'t��� � t
'"^ri- ��ASSESSDR�IISE ONLY ��`�"�"`' �TRUE TAX � ASSESSED VALUE e'�'F10MESTEAD NON=RESIDENTIAI:
`}� r � > � '�* `� �f+VALUE:�sk ATt100%.OFTfV� �,�VqLUEr� �y�`�",�cj:�V/1LUE � �,?�,�F���
�r.d'. ,�,�..�= a,S ,a� _��. ? as��`e,y .�-__...,-
Land not exceeding 1(one) aae immediately •� ��._ u -r, e
surtounding resitlential improvements. (�� �A,����� :�m ... � ��,''-_;
Other land 2 `-�'i`���`''��"�:�
( ) �s��i�� �
Tdal land (line 1 plus line 2) �3)
� >�—.n:ZF�`��T'1}'rH':i�Y� .,_ . :c
Dwelling (4) ��;�,n���-�'�� '� ._"`-,"�, �< � '
�ResidenGal improvaments or Mnually �. �A'^`�_ ��k•�''�-K ,
Assessad Mohile / MarnAactured Hortre Garage (5� �� � . - � � � a- .Y' �
a�,� -,:-Y�::�����
� ;��: ;.. -.._ >
Otherimprovements� � (5) ��'.L�rJ-; �
�.'+"^S��a-J.°- s3:v�•�.
Tdal improvemenLS (line 4 thiough line 6) (��
Tctal value (line 3 plus line n (g)
I hereby certi(y the above is We, coned, and Signawra of Assesmr Oate signen
complete.
VeriFjirg actbn - Signature oflwaitor Date signed ,
�� '��'.�''`�=ak�':�dtc`x+"`t��:.:,�"°.:�3,�r.�.�:'�iSTANDARU:DEDUCTiONALLOWAHCE��o-,�'"'.�-,,,�'��-z�,-�".„� _�-�' ',��,`�':;��
20 _ Pay 20 _
Lesser d 112 Homestead
vaivauon or E35.000 S
Signatura of Audilor " Date signed