Homestead_Emery •
STATE I ORM!)!• 'IC/-fl TRFASII[ER FORM TS-IA
n,Rrn'En BY S1■TE BOARD OFMMRI\'R.an, PREYAtamD BYTnr DEPARTED?OF LOCAL IXK?LNMIWTFINANCE ICt1.1-L'4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 hWividuaLs and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
mote beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher is%bills for all:therefore.
IIII HE/t 1341-2000 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene 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 he accessed by authnrintl county officials.'the Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Emery, Ross E/Jenny e .
- .__ — — --_ - . — __ _ _ - -- ,–tau stack lN47639_ .__
10926
Ross E Emery
11350 S Brookview Ct State Parcel Number Legal Description
HAUBSTADT IN 47639-7853
II III u II I I I II I I I II I I I I III 26-23-11-200-002.187-024 WHISPERING WINDS SEC 3 LOT 21 D-10
o nt
t t n t r it nr n n a nt n t t t
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
oSS Eclu)o.-.✓al Lrn2ry
•vg Address(number and street,city,state.and ZIP code) — - - —— -- Same as praperiy address— _- - — - — - -
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) 2.Same as propeny 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 Dale
•
; CLAIM FOR HOMESTEAD PROPERTY TAX
• CREDIT/STANDARD DEDUCTION
\ � S�a�e Porm St73 (R6 / 403)
PrescnOed by the Departmenl of Local Governm¢n� Finance
INSTRUCTIONS: See revc�sc side !or /iling ins(iuclious.
�} _ f' _ s
„n� FORM YEAR
;V\ Hcio
-::�TS�t.._A::�'1>._,i� 't.,..._ . ..... ...- ... CERTIFICATONSTTEMENT'. -.-:,. � " � r.,,�.'.y.
- _... . - g �. 6 .i. '
' �e' � � .
certify lh��e�sQd�Q{}.�narch, 20
�I e) occupied as our principal place o( residence e ollowing des ib d real property for hi a Homestead Property T�c Credit is hereby daimed:
(We) owned ❑ Are buying under wniract �-�.j.j �
,� F- �i .�6�
Have a benefidal interest in the entity that is liable for the property taxes on the proDerry and that owns the property or Cs�buying pQp�,�yontract.
If bvying an conirad. Fee Simple owner's name
Recordefs olfice where contract is recoraeC
CwnN Toxnship
Parcel numDer Le9a� description
�i -�o�i�C�
tl any ponion ol the resitlentlal strudure w ehe lan n exceedi
ol Ne property utiiized to produce inwme. /
_ _ �-., :,...
Record number Page
) O�,Q� � // I Is ihe Pro6�Uy i9qaqsiion: l )
(nto% /u�eal�pmperry ❑ Mobile Homa I.C. 67J4
one (1) ac�that immetliatety surtounds that sWUUre is used b protluce income, dewibe the use and portion
�� �
County I Tvxnship
I hereby certify lhe above statements are W e, cortecl and wmplete.
Addreu (number and streel, ciry, sfafe. ZIP cotle)
� v�{
MANT IN�ATHER"COU
Counly
n ol c imant
�(Y� �
� '=::;ati[,:�
Toxnship
�.i�.v��'?"' ASSESSOR�USEONLY . � � . TRUETAX � ASSESSED VALUE �: HOMESTEAD� �-' NONi2ESIDENTIAC;.
�'�'•���t..��:r.:.: .�„-s�i-'�""� _ - � ' VALUE �AT100%aOF_TTV 'VALUE ' t_;. '.;it1 VALUES�: .
Land not exceeding 1(one) acre immediately .�i -�;Q - '.
surrounding residentlal improvements (�) _ • - _., �
Otherland (2) - _ �
Total land (line 7 plus line 2) � �3) �
Dwelling (q) .- `^ ..
ResidentialimprovementsorAnnually �x.•�'ar. �...
Assessed Mobile I ManufaUUred Home Garage -;'!w� =�;cti'-+,.`c;;�z-.-.- . �.. _ , .,'. � .
(5) - .- ,_ . .
Oiher improvemenis (6)
Taal improvements (line 4 through line 6) (7? I I
Tda� value (line 3 phs line n (g�
I hereby certify Ihe above is lrue, conect, and S�gnawre ot qssesmr oaee sgned
complele.
Ven(ying action - Signawre oflwditor Date signed
i`?i-'_���%?=.`.;.'� ' - -STANDARD.DEDUCTION
,: 20�Pay 20� � �
Lesser of 1i2 Homestead 5
vauauon or 535.000
i
Date signe0
