HomeMy WebLinkAboutHomestead_Whitehead (2) STATE FORA.53StA(U/&10) TRFASLROI FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS X09 PRESCRIBED BY THE OFPARTME\T OF LOCAL CObTR%ME T FWANT£IC 61.1-224.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS -
101 N. Main Street .Individuals and married couples am 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 Lax bills for all therefore,
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to Verify that they are eligible to receive the
I' I benefit and to prolific additional identifying confidential a
ng 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.
PART L: PROPERTY INFOR:\IATION ' ' -
APR 18 ''- •
Taxpayer Name Location Address
C Whitehead, Jay D/Karla K
412 E 795 S/APACHE DR
GIBSON COUNTY ACID TOR - . - FORT BRANCH IN 47648
2613 - - - III II I �( Ip� I II
Jay D/Karla K Whitehead IIIIrIILIIII III I .III III IIIIIIliiII�IIuuIIIIILIII IIIIIII_IIIIIIIIIIIII_IIIII_II
412E 795 S
Fort Branch IN 47648-8015
I'll'lliiil"'1I" 'I
� 1"III 1III1"III"1Ill1lll1tlliIiiI'I'I , State Parcel Number Legal Description
26-19-19-200-001.320-026 INDIAN HILLS 80 D-27 ,,
. - - 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.-
YI . . - • PART 2:TAXPAYER INFOR'SIATION • . . . . '
First Middle - Last
Mailing Ad (number and street,city.state,and ZIP code) V Same as property address
yii g 7grf - -
. .
Spouse �� First / Middle ,` /������ Lori
Mailin Address Number and sncet,ci estate;and'lP code , '�- - —^� —^ 4—— -.:- {Sammee as property rddmss _ .• - °< °
g" G ty'. ) �� " ,
_.
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 1 Si: , Date
.
�?•�° CLAIM FOR HOMESTEAD PROPERTY TAX
d t
''�- " � CREDIT/STANDARD DEDUCTION
'� � J State Fortn Si73 (R5 / 70-07)
Prescribed by 1he Department of Local Govemment Finance
INSTRUCTIONS: See reverse side (o� liling instrucfions.
FORM
HC10
YEAR i
-�,�.fr � _ _ - �� . �CERTIFICATIONS A7EMENT"� �� - - . �
I(We) ., certify th th ts day of ar h, 0
I(We) occupied. our pri ci al place of residence the following described real propeAy for which a Homestead Pr erty i is hereby daimed:
❑ I(VJe) own . Ne buying under coniract 0 C� 1'7 20�2
�4ave a benefidal interest in the eniity Ihat is liable for fhe pmpeAy tazes on the property and ihat owns the property or is buying unde! a contract.
If 6uying on conVad. Fee Simple ownefs name
Remrders afice where contract is recorded
County
� "r . ..E.' _
; Tamship ' �.. i,'°• �.
ESCRIP,TION-:=`: .. r'-: �
T�cing dislrict (ciry, fowq fownship)
Record number
Page
P c I�l/lA/ [iZ/ I L a desaip�ion , �LCI.V W I ls Ne �roperty in queslion:
��� ❑ Real pro0erty ❑ Mobile Homo ll_C. 61.7-7)
If any po�ion ot the residential sWCWra w the IanA not exceetling one (7) acre t0at immediately surrounds ihaf sWCture is usetl to D��uce income. desrfibe the use and poNOn
of the property utilizeA to protluce income.
lilCo -/ 7�/7-
�� :z.- hc,f�+��. sj s+, - a.i?=.
Coanty
Tavnship
I hereby certify the above statements are true, conect and complete.
stree(,
�71 i
Counly
�
������ASSESSORUBE„ONLY �.-; �J �x.yy ,rTVALUE , �AAT.100%OFT7V �HOVALUE D ., � �lNON VALUE$T'..`Y�i�'.
x-as,:,� _fr s.,-ai. .�.. _'c� Ta+`._ . e e+. ...: �� .'u .W..�
. _ . _ _ .r.. _ .. .a_.__ _ .. ..�... -
Land not exceeding 1(one) acre immediately - f 3� ;"� 5� �;3� �;
sunounding residentlal improvements. (� � ' , s �5 ;`�� � � �'�� ' �
�` '
Other land (p) � : t, �r+ ��
- ^..,, r ..r
Tofal land (line 1 plus line 2) (3�
.. r'.� i �. " - 'k'z r . �.i
Dwelling (4) �'?.�,, �-rr5.`o�'� s�-t;j..•'x.'1_
Residential improvemenLS ' ,�, �'� �� � '' � ' 1' � r't
��.(yi^k�.��,�`� � � /�: ,
Gara9e (5) Hx-�� ,�:-..�Y.��'i�-ya,x'>-,.i.�
_'f�i. . .',`,'-�_da�,:-! -
Other im rovemenls 6 - � s� �� ���'
P ( ) . ���� ; -�' -y
`i<:.,.:,..�
To[al improvemenis (line 4 fhrough line 6) (7� .
Tctal value (line 3 phs line � (g�
I hereby certify the above is lrve, correct, and S�gnawre o(wssessor �ate signed
complete.
Veri(ying aclion - Signature oflwtlitor Date sgnetl
20 _ Pay 20 _
Lesser of tl2 Homes[ead
Valuauon or 56,000
5
Signature of Auditor ' L M' � ^,�O' L�� � I Dateisigp�d _ I��
%� r� �[�