HomeMy WebLinkAboutHomestead_Miller (15) STATE FORM 57569(RIIS-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVEFLNMENT FINANCE IC6-I.1-22-8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
cuction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
auses 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: PROPER Y INFORMA ION
Tesoaver Name Property'Address State Parcel Number j.eeal Description:
Patricia Miller 9 W RED BANK RD 26-18-24-202-000.719-026 PT NE 24-3-11 .12 AC
FT BRANCH IN 47648
Complete and return to: ,at,, m to mnnamtlanTlaRn
111111111(IIIC�EIEIBi° fllpliilll tlilillanElli t itil i
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
'PART 2: TAXPAYER INFORMATION'
Owner Fuss Middle 11 Last
Mailing Andress(number and street,city,state and ZIP code) ,v I Sartre as property address
Spouse First Middle Last
vim• �YI�e S YMN G rn e
Mailing Address(number and street,city.state and ZIP mde)
rz, Same as property address
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
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�_ ' CLAIM FOR HOMESTEAD PROPERTYTAX
CREDIT/STANDARD DEDUCTION
t State Fam 5473 (Rfi I403)
' Prescribed by Ne Depar6nartt ot Local Govamment Finance
� INSTRIJGTIONS: See` verse side fir filing instnictions.
/ -
FORM --- r� YEAR
HC10
I(We) � certiry���t y°n �the71 st day ot.March, 20
I(We) ocwpied as our prindpai place of residence the fdlo 'ng described real properry for whfch a Homeslead PMp§rt�l+Tat C��s hereby daimed:
❑ I(We) ovmed ❑ Are buying under contraa `�y�
� Have a benefidal intarest in the entiry that is liable for the properry t�es on the property and Nat owns the pi'o"�r��'vyCtq under a conVact.
If bu)Mp on conusq, Fee Slmda ownefs name
oftice wnera comrea is recorded
r.W
i
If any portion of Ne resid
a Ne PmPertY util¢ed w
>�a �� oC��— ll I Is Na pro
or Ne land nol excaeding ona (1) aae ihat immediatey surmunds Nat
Racord number � Papa
in question:
�Real proparty ❑ Mobile Hwne (I.C. G7.1-�
Nra is used to produce income, describa Cie usa an0 poNon
� a 'w '�:"'3' 'si�"'-�f2-ti�ui"_-`�fo'Sx'..s n'�'z� �+ - - i z . . ..._ . �.:aa; . ._ . . �� �
r' ��'" �'r ASSESSOR USE ONLY� '�'''� R F`�' TRUE TAX� ASSESSED VALUE HOMESTEAD >„ � NON RESIDENTIAL } ��`
�.��+�`��.,.�tw. u_�4:chY�±n2.�.tT+.ri�.`��-���?,.:t:;'* VALUE��`t AT.100%OFTTV_ z.�-�=VALUE�- y� kL,,"y:'-viVALUE. c� ¢� z'�.
Landnotexceedingl(one)acre�immediatety � �ay,��� �?`"- t,"r`;�"'x
surroundingresidentialimprovements. � � �.i �, ��x� �� .�.�,;;+� 3�,—�i�
Other land �y� '�- :r _ <c� `i a {`'
.4Y :
Tatal land (line 1 plus line 2) �g�
DWBIIIf19 (4) -�— 'a'� �4 �v�.�f'`f S'i�c��Y,� #-`a
ResidentielimprovemenLSOrAnnuaDy + � r_.�..'�-i . :r
AsseuedMob�e/ManufacturedHome Yt ii.z..}�� r:.�F�..-
G2f3 e � � `•. . �' j: r '6 t '-
9 5 ?�` �-.--w'�.-.���',,...:. :�,4:'.i �`{ �. -
O�qet improvemants (6) z "y'� "
Tdel improvements (line 4 through line 6) (7�
TKaI value (line 3 plts line � �g�
I hereby certi(y the above is We, corteG, and � Signawre oiAssessw � Da�e signed
completa.
Veiymp ection - Signature oflwditor Date signed
20 _ Pay 20 _
Lesser of 1!2 Homestead
Valuation or 535,000
S