HomeMy WebLinkAboutHomestead_Pohl (3) STATE FORM 53569(R3l&10) TREASURER FORM TS-IA
APPROVED BY STAtE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL.GOVERNMENT FNAMCE IC61.I-22-41
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
deduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
•uses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
sr4ndard 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.
•
• PAR I: P'OPER Y INFORMA ION
Taspaver Name Property Address State Parcel Number Leval Description:
Melinda R Pohl 102 W MULBERRY ST 26-18-24-202-000.076-026 MCCRARY ETAL 83PT
FT BRANCH IN 47648
Complete and return to: I®IIDl]EfM It1 WU]IIIDQI Ip W®O®UDL t
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 IIJ
PART 2: TAXPAYER INFORMATION • - -
Owner 1 First Middle Last
Boll(da r �k
Mailing Address(number and street,city,state and ZIP code) Dame as property address
Mailing Address((umber and street city,state and ZIP code) Same as property address
Social Security Nuber(last 5 digits) Drivels License/State ID Number(last 5 digits) erase Other(please specify in Part 4 below)
•
PART 3:'CERTIFICATION
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.
• . 1 Signalise n Date
( )
PART 4: ADDITIONAL INFORMATION
FILE D__
• MAY 1 2012
GIBSnM COUNTY IGK
.; CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
/ Sla�e Fwm 5473 (R6 / 1-03)
Prescnbed by Ne Departmen� of Local Govemment Finance
INSTRUCTIONS: See revcrsc side lor liling ins6ucfions.
FORM
HC10
YEAR
� M�e) �.r� L�,� ��(N"� j�� certify that on the 7st da�ofMaOrch. 20
I(We) occupied as oUr principal place of residence the following described real propeAy for which a Homestead Property Tme Credit is hereby daimed:
/ �
❑ I (We) owned ❑ fve burng under conUact . ---�-•�1 �.�� . /� �
, Have a benefidal interest in the entiry that is liable for the property taxes on 1he property and that owns ihe property or is buying under a conVaU.
If buying on contraa, Fee Simple ownefs name
RecoNefs office whera contraa is recorCed Record number
�'��: ��YS°�-.t�+��.in: �����°:�f'"�� °P,ROP,ERT.Y:DESCRIP,TION�?7`�''{ _, :�.'�!-.'�` '� '
n Toxnship Tacing dislrict (ci o i
Par num r Legal Eescription Is �he pm � in queslion:
eal property ❑ Mobi
If an�c�t,ot�r�ti�i�s� w the land not eaceetling one (1) ave that imme0iatety sunountls that sWGUre is used lo produce income
Page
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the use and portion
20 _ Pay 20 _
Lesserof 1/2 Homeslead
v�ueLOn a 535.000
3
Date signed � _��
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