HomeMy WebLinkAboutHomestead_Witherspoon STATE FORM 53569(015-10) TREASURER FORM TS-IA
APPROVED BY SATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.I-22.8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS ; '
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
'°duction 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.
PATE PROPERTY INFORMATION
_ I•t: ,..
Taxpayer Name Property Address State Parcel Number Leval Description:
Ronald L W ithetspoon`P s cp 1013 S MAIN ST 26-18-24-204-000.010-026 PT NE 24-3-11 .2817 AC
`�eyys. o n'Aces?o FORT BRANCHfN4i648
_ complete and return to: 11111IIUD]CIIluICIELEI Ih 11111111 11[I1 111Dll:1(ffl
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2: TAXPAYER INFORMATION 21.0a %
Owner 1 F'st Middle Last
c rte 7 , itirf Aeias p oo 1i
Mailing Address( and street,city,state and ZIP coda) (�
d111e as property address
1413 S rnglu st Foes tees,1/4c), tf7613
Space First Middle Last
Mailing Address(number and street,city,state and ZIP code)
Same as Properly address
Social Security Number(last 5 digits) Drivels License/State ID Nurnber(last 5 digits) Stale Other(please specify in Part 4 below)
_'.. ._. I • ,$T.•7• CF-•T.IFICATION - .': .. ..i :?r-.....-.
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 Signature Data
-' • 'PART 4:•ADDITIONAL INFORMATION,..`; y ::'?__
N0 6 a ��. FILED
• JAN 1.8 2013
0I133ON COUNT/ Al InITOR
i/ .— _—.
. ' CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
t SWte Form 5473 (R6 /4-03)
� Prest+ibed by the Department of Local Govamment Finance
� INSTRUCTIONS: See �evarse side for filing instructions.
FORM
HC10
YEAR
;.sti-,��:�ta_:��-„z�i�t�,r.. �::.� 4 :�;�-,,,:7�-^�niiricnnunsrw eN7.��.�. . - _
->Y� � .. �.�.,� .- . ... _, . . � . ..: .. .
� iWe) �'�' certify that on the tst day of March, 20_
I(VJe) occupied as our prindpal placa of residenc the tdlowing describe eal property for which a Homestead Property Tac Credit is hereby daimed:
�I(We) owned ❑ Me buying under contrea
Have a benefidal interest in the entity that is liable for the property texes o� the property and Nat owns ihe property or is buying under a conVact.
I( buying on conVact, Fee Simple owners neme
Retorders ofice where conVaa is recorded
Rewrd number � Page
Counry TarmshiD Tmcing dis ', ciry, fown, towns iP)
P I number L de � tion Is Ne pmperry (n questlon:
— — — eal pmperty ❑ Mobile Home (I.Q 6-1.7-7)
If any portion of the residential sWCWre a Ne land not ex ing ana (1 � ecre Nat immediately surtounds N sWCture is used 10 pruduce incoma, describe Na use end Oortion
N Ne property utlfaed W produce incane.
#�*:•a`�:�t'.�` �'"r.� �'"`�`.��"��_ �` i K=�PROPERT,YOWNEDiBY:CL'41MANT;IN'�OTHER�'COUNTIES�-Y � �"t` "`� ��v � -� x�'.''- �"
c..�..., _ � � :
County Twvnship Counry '�� Twvnship
I hereby cer6fy the above statements are W e, correct and complete. Signature oi deimant
ress (numbar and sUeeG ciry, sfate, ZIP code)
'r'.uxz��}�ASSESSORUSEONLY��y���i�y ��UE:TAX � �.�ASSESSED�VALUE HOMESTEAD':�;4�'` NON�-RESIDENTIAL�- ��'
�S ... tia�/��.^;.s.i?:_?^_:��j'.�:it,.•-.a�3)�z < a�� F- ; VALUE �. .F �.AT-1009GOFsTTVo �.�'.e+-VALUE� �' `<.: � �i:VALUE� A�:r:�;.�; `'.
Land not exceeding 7(one) acre�immediatety ;�x.� ;'' k""' �i ;;^� y� .`
surtoundingresidentialimprovements. ��� "�,.��_:����y�,-,�,.�:.=;��,„:,.",'�
Otherland �p� f _�
Ta[al land (line 7 plus line 2) �g�
Dwelling (4) i -+ir fSJ.F,`,T5 +� ...' 4 f'�r+
Residenlial improvements or Mnualty �>,ke ,.x, � y.;. ?:�.
0.ssessed Mobiie / ManuFactured Home � :�^a:� .��. �� 4t�; � °
Garege (5) z: L� S=�is � j. „-;�. ;:�,
� r X'
O�4elimprovements i8) � ��`,.�.^i�.�s.,=:%�`?
Tdal Improvements (line 4 fhrough line 6) (7� .
Tctal value (line 3 phs line n �g)
I hereby Certiry the above is W8, correct, flnd � Signawre ofnssessor - Da�e signed
complete.
Vuilying e Won - SignaWre otAudita Date signed
,',� 'i?'i�'�"��.�:� �.�3`�,�`_���_`{++,L"'.9�,'„{c`Fy-f?aa.'.S,�=STANDARD;DEDUC.T70N'ALLOWANCETiw �� �..' z -�??z - . „' . =�
. ; Y. t� z � 3.`. :
20 _ Pay 20 _ .
Leuer of 12 Homestead
� aluation w $35, 0 S
SlpnaNra otPuditor Da; signad' _ �