HomeMy WebLinkAboutHomestead_Shackelford STATE FORS!5)569(R35.10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2003 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1-22-9.l
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS ,. t ''"
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
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 wPARTI:: PROPERTYINFORMATION' '.;, ;,r, ? "":`
Taanaver Name Property AddreS5 dlate Parcel Number Lees!Description;
Ryan P Shackleford 211 MCCREARY ST , 26-18-I3-404-000.060-026 SYMONDS ENLG 200P17201 PT
FT BRANCH IN 47648
•
Complete and return to: • iul iliiiiu uuu uoutauilui'illiiiWlliliiljliiliiiii �Il
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
. . I PART 2:TAXPAYER INFORMATION '''..,:r.-..*!- ,. .: ' ,; * • e * s
Owner 1 First Middle Last
Z44- 40..1-(_IClL- S1LtLC.k ELF 0I4�
Marling Address(ranker and street,city,state and ZIP code)
0Same as property address
- •
Spouse - ` �• Fist Middle Last
R15T1 iu P6Vt3\-/ 54PCKR_ R iZIM
Mailing Address(number and street,city,state and ZIP cede)
`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
I t
9•F NOV -3 21Y2
av;szvcsa.lovn, Ai;girV3
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5/73 (R6 / 4-03)
PreaWDeE by Me Departrnenl d Lxal Govanrnmt fumarice
INSTRUCTiONS: See iewraa dda b6ip iuburborq.
FORM �� YEAR
HC10
��e) � certify that or�t�eF1 s�f oL(, h1e�' 20
I(We) occupied as our pnncipa lace oi residence Ihe following described re property for which a Homestead Property Tac Cred�ishere'by daimed:
❑ I(We) owned ❑ Me buying under wntrect �h,a� ��
a ��
, Have a benefidal interesl in ihe entity that is liabte (or the properly taxes on ihe property and that owns the pfpp@rty or is pnying u�r a contract.
If buying on coniraq, Fea Simple ownefs name
Remrders office where contracl is recorded
County
��� r 6..a�
If any porlwn o( Ne resiC
ot ihe ProP�Y util¢ed tn
CouNy
w Ne land
Tawnship
one(1)aae
I hereby certify the above statements a2 We, corred and complete.
ddr� (f um6er aM streef, cily; state, ZIP cade)
X'�. � � W- Wl � Ct n�r+n✓ S� . �-1 �
Rewrd number � Page
7aing Aistrict (dry, fown,
properry in que5tion:
❑ Real Droperty ❑ Mobile Homo (I.C. 61.1-�
Ihat sWCture is used to produce income, describe Na use and portbn
�,
Caunty
SignaWre of daimant
G. , � w
Toxnship