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STAL-EF0RN 51569(R3/8-10) TREASURER FORM TS-IA
,:TWRO VED BY STATE BOARD OF ACCOUNTS,2009 - - PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.I-22-8.1
IMPORTANT NQTICE TO HOMESTEAD PROPERTY OWNERS .
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
aeduction 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 PROPERTY INFORMATION j. 51
Tasoaser Name Property Address State Parcel Number Leeal Description:
Jamie D/Ruby M Moore 744 w 800 S 26-18-24-204-000.530-026 PT NE 24-3-11 .25 AC
FORT BRANCH EN 47648
Complete and return to: In9 EOPREIMIMIRVIrgPmmpIN
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
•
b. PART 2: TAXPAYER INFORMATION i`
Owner I First Middle last
(//J//7//- j7• 7/100/rr
Mating Address(comber and street,oty,state and ZIP code) r\A same as properly address
7`/147 'DO 6S. 70 /zvke7-2.! • A-06t 5/76 Vet
/
sp— No Thz4R First Middle Last
ruby ,G1- \ .410Ot'F
Marling Address(number and street,oty,state and ZIP code) rli Sense as property adaress
7VC X/ 7o o S. a mite 1 -
_ - •E' I . 10 4';`: _ .___ �.:,. a, .„4 _x5:s;:s.
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.
Ow t Signets? Date
/19077or 1f.
PART 4: ADDITIONAL_INFORMATION,`_. "
.. . ,. .
J1Jfl
• NOV 2 202 —
c-1r('.. rV\
GIBSON COUNTY AUDITOR �i
d���,e CLAIM FOR HOMESTEAD.PROPERTY TAX _ FoRM YEAR
:� y = CREDIT/STANDARD DEDUCTION - --�HCio (�'p �
��� State Form 5473 (R2/1-90)
'°�• INSTRUCTIONS: See reverse side for filing instructions.
. dl� -dOS'�:�0- �
CERTIFICATION STATEMENT ' � .
I(We) "` � �J certify that on the 1 st day of March , 19 ���-
rWe) oc u ied as our principal placeb esidence the follo "ng described real property for which a Homestead
Property Tax Credit is hereby claimed: I(We) owned ❑ Are buying under coMract
� Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
property or is buying it under a contract. . .
If buying on contract. Fee Simple
Recorder's office where contract
Township
CONTRACT RECORDED
�
PROPERTY DESCRIPTION
U/]-� Obs3a -�o � ` V T' N� ��-F- 3-// . I
If any portion of the residential structur or the land not exceeding one (1) acre that
ture is used to produce income describe the use and portion of the property utilized
PROPERTY OWNED BY C
Township
siatements are true. correct and
Address (Sireet, number. city, state
IN OTHER
re
e
Record Number • I Page .
n, town hip) .
..1.��4h .1�1ob, �-
� MoM�-
nediat s r ( tr , -
xodu in ,-
MAY 01990
�NTI ' - �
_ R�.:� I
ASSESSOR USE ONLV TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land noi ezceeding 7(one) acre immediately
surrounding residential improvemenis (�)
Otherland (Z)
Total land - line (1) plus line (2) (3)
Residential improvemeNS Dwelling (4).
Garage (5)
Other improvements (6)
Total improvements - line (4) through line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990 1990 Pay 1991 1991 Pay 7 992 19 — Pay 19 —
Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or $2,500 Valuation or $2.000 Valuation or S1,500 Valuation or �1,500
Auditor Date Signed = .
_ ,.,. . � � � �,(�_ S- /� -9 (7