Homestead_Stevens • TREASURER FORM TS-1A
STATE FORM 5350 STATE(DJ OA R)
AMROiF➢aY SrwTF.BWRn oFAttOUVFS.mg PRF_YRIaID nY THE DEPARTMENT OF 1[1ULG0\TAYME`m FINANCE IC 61.1-224.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
Princeton, IN 47670 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
0 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.
FILED PART 1: PROPERTY INFORMATION
Taxpayer Name - Location Address
MAY 6- 2011 Stevens, Billy
207 N Main
C�.n
Fort Branch IN 47648
74 ' '
GIBSON COUNTY NTY AUDITOR I hi II I �II I ill Stevens
207 N Main St I II1IIIIHI O II III 0111 1�II�II�II II�IIOII_II III[lul in
I
FORT BRANCH IN 47648-1001
IIIIIIIIIFIIIIllllIlIIll'IrIIItII'lltrltlllltltlllllll'III' 'i'll State Parcel Number Legal Description
26-18-13-404-000.234-026✓GENUNG 8 WALTERS 158PT
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
!an a 10,20 SIGN la EM IC:Mai in — -
/
( r 1 First Middle c Last
�
V \\ _ C:1)ail\ S-tv t.sn S SY .
Mailing Address(number and street,city,stale,and ZIP code) ❑ Samc as property address
D., V GNI\\/\ t,.;v. CICittX FINN c3`I a•r•�� .-\IN. VC t16tYE
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) 9 Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
I I I I I I I I I Stet
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 fmancial penalties.
Owner I - Date ,
f'
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�
�
f1:
`
"'" CLAIM FOR HOMESTEAD PROPERTY TAX
i _ , STANDARD/SUPPLEMENTALDEDUCTION
SUte Fortn 5473 (R72 / 6-09)
S � Pfesaibad by the DepartmerM1 of Lo�l GovemmeN Firmnce
INSTRUCi10NS: See ravarse side for fifing inshuUions.
YEAR
. .
' I(We) . certify Nat I_(we) ocwpied as my (our) prindpal
place ot residence or a re) buying the following described real property for which a Homestead Property Tax St�yo�iQqedu�'i� hereby daimed
under conVaG on the d Ihis appli�alion is filed, (date of filing): Q �
GIBSON COUNTY AUDI'�AH
I(We) own ❑ Am (are) buying under recorded contrect
Am (are) entiUed lo occupy as a tenant-stockholder of a cooperative housing corporetion
� Have a benefidal interest in Ihe Wst or the right m occupy the pmperty under the terms of a qualified personal residence irust
•• . •
Nane W da'unant (kgal nertre) .
Sodal Srnrtiy nmber
Sodal Seamry numEa of tlaimant's spouse (last frve 0'grt.v) Dtivers Ocense / ICentiYation / ONer numCer Iswing State
� of daimant's spouse (la4 Rve dyits)
• •�� �
If buyvig on crntrect, Fee Simple awnefs name .
ReoDrtleYS olfice where mntraG is fM»rded ' � Remrd number Page
. . � • - � • •
Coun Township Ta�mig dt5trict (dN• Mwn. fownship) �
a� - -/3 - o_ �00.�3 S� oa
ParrnJ numher �Gtim . Is Ihe ci question:
' Reat yoperty � MnwAy assessW moWe home (IC &f.7-7)
If any portion ot tAe fasldential strucNre or Ne IafW rol ezceetlhg me (1) acre Ihai immediatety wrtou s that sWC6ua b usad to pmCUce inmme. desm'be ihe use and portion
' u� me wovam wT¢ed m proa�re inm�.
-�• • �: • •
CounTy Twnship Counry Tmmship
I hereby cerlify the above statements are We, correcl and complete. Signa o1 daima , �
�fdAress (num6ei and sfreet, dry, slate, and LPoode) .
2 0 �1 N , Ma.r ��: F� �Y � � �N �`t b�'�
�. � . . .� . ,
�� .. '
Land not ezceedin 1 one acre immediate ��`"`�-''���g���"�
sunoundin residentiel im) rovemen�. y (� � �u��"�s�* ��' ��g ���
s.:..;�_:�_.:'g"..:' -K-cFaC- z
�i
Other lantl �2� ��J��. .
Total land (line 1 plus IineT) (3)
Dwelling (4) �.��a`�'..L:.-�a�.��•��i�
ResldentlallmprovementsorAnnuauy ��'t' �'�x�'���T�*•`^
Assessetl Mohiie / Manufectured Home 9 5 ��..� �^ 3..#�F�:,� k"`:
Gara e
� � ,}� ,,�v�. 4's»tue-......'•�k.:.^:. � `-'�eTM�' `i6.3: ......^:
Other Improvemenb - (6) ' �_'�'y'�N���,'�,3c'ky?.!,hiy.���
Total Impmvemen6 (line 0 throughline � (7)
roa� va�ue prne s w� ane 7) (6)
I hereby certity the above is We, correct, Sig�anue otAssesmr Da:e signeA (rtronN, Eay, yea�
and wmplet¢. �
Veiyi�g aUion - 59nawre olAUditn Date signed (month. dzY• Y�)
� . �.-� � � • • • �
20 _ pay 20 Lesser of 60% of Ihe assessed value of the homestead or $45.W0
Nofwil�sfaritlirg enyWher proNSion, the sum W Ihe deducliwu pro�rdetl in IC bi. f-7Y fo a mob�7e lrome tha( b $
rwt essessod es real property w to a menNaUUred home Net a rpt essessed es real properry may not erteed _ ..
onehaM (iQ) d Ne assessed relue W fhe rtrobile hane or manu/aGUred Awrre.
SlgnaW�e of hMiNr Date signeC (rtinn(h, Eay, yea�