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Home My WebLink AboutHomestead_Chamblee STATE FORM 53569(R315-I0) TREASURER FORM TS-IA APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FIN VCE4C6-1.122-8.1 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 cruses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead si ndard 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. PART]: PROPERTY 3'FORMATION Taxpayer Name Property Address State Parcel Number Lent Description: / Steven R Chamblee 2846 W 1125 S 26-22-10-200-000.310-024 PT NE 10 4 11 6.305 AC HAUBSTADT IN 47639 Complete and return to: II IIIMIEME Mf111q I 311111l6IIlm [II GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 4716701 ll� IIJ LLllnllll Ill PART 2: TAXPAYER INFORMATION • • '• t Omer 1 First Middle Last Stuff e,r) R,a ki Ch itryi bi e -P Mailing Address(number and streeL city.state and ZIP code) I I Same as property address a8 L ) I1 as S CV(Ln6vi I le . IN I-) CP 3q First - Middle Last U.5 tit - nn CU' i f. C)ha irbi e Minting Address(matter and street.cty,state and ZIP code) I 4Same as property address a8�t U0 I I aD S Ran-6V' I it2 ,1k1 1-t-1(03cc 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 Date . • PART 4i,ADDITIO\AE IP.FOR\I-TIO,N . • NOV 7 2012 GYBSON UUUNI Y NU IUR 4 rt� e CLAIM FOR HOMESTEAD PROPERTY TAX - � CREDIT/STANDARD DEDUCTION '� � State Fwm Sa73 (RS / 10-01) �� Prescribed by lhe Department of Local Govemment Finance INSTRUCTIONS: See reverse side lor (ling instructions. FORM � YEA Hc,o 6 6� � � � � � I(We) V" �c �.).1LJ I1/�'V �/�_ certify that on N(e` 1 st day ot March; 20 I(VJe) cupied as our principal place of residence the following described real propeRy for which a Homestead Prope � ac Credi " ereb� aime i(We) owned ❑ Are buying under contract GIBSON COU i Y AUDIT� �4ave a benefidal interest in the entity ihat is liable (or the property taxes on the property and that owns the property or is buying under a conVaG. If buying om m�Uad, Fee SimD�e owners name Recortlers oifice where contrad is recorded • '-�EiJ[�-.� -T. ^X,;?�+, L'"` .y•�,c� <�'?�•FF-� ��F4'F.'=$"+'��'.'.`itx'-+Mh v� County Tomship description Tating bTnct dt ta townshrP) Isth propertyin puesGoi Rewrd number � Page J� U V. �� V y+� I .tJ neal property ❑ Mobile Hwno (l.C. bf. i-n portirn of Ne resiAential sW qura w Ne land not exceeding one (1) arre that immediatety wrtounds Ihat sWCtura is used lo produce income, describe tha use and portion praperry utilizeA W produce income. �;/�//�i///n I hereby certify the above statements are We, coned and complete. � A�dress (number and stree(, city, stafe, ZIP code) � ^� 39 Tavnship �'� ' �`� '�"��'�'� s4�"��' '�t`'tTRUETAX� ASSESSEDVALUE �HOMESTEADk'� �`' N N�RESIDENTL4L��^-� a ;ASSESSOR��l/SEONLY � � `�- �a��f �-r��y,t�g�gr� E� F i� �� `�rVAI:UE�.�.�� AT 100%OFATTV� a�� VALUE�tlte+°. ��'��`��.�VALUEr'�,,,,,,�-,^'t�,�`idT•_ Land not exceeding 1(one) acre immediately `-s..�°y`x��`r'�-';��y"R, � .�%�,+��a surrounding residentlal improvements. (�) :�`�-�Y ��,�'�`�'�� ;.'-.� c s ��q-r.. Other land (2) ��-��;:�'��.�y"t � �::Ew�."`�-�� Total land (line 7 plus line 2) �3) .-+e-tr: z��fi"��F� �'3 Dwelling (4) �: ..r#�r::;.�.�...' Residen6al improvemenis � ''�'�"r��-+''�`�-'�_�'�� Garage (5) ��,�!.,,r�� ` ? 'ss�t�_ �'e�,"'"r.��•'; 'j. i�3.�i��}�'^.3,;5.� Other improvemenis (6) c � r' "`'� ' ' s�� TUaI improvements (line 4 through line 6) (7� TUaI value (line 3 plrs line n �g� I hereby tertify fhe above is We, torreU, and Signature o(ASSeswr Date signed complete. Veri(ying action - Signature oflwditor Date signed 20 _ Pay 20 _ Lesser of 1/2 Homestead Valuation or 56,000 Signature oflwditor S ^9�-O