HomeMy WebLinkAboutHomestead_Freeman STATE FORM 33509(P3/840) 7.S•4544131 101124 TS-1A
APPROVED BY STATE BOARD OF ACCOUNTSIM PRESCRIBED BY THE.ndARTME'T OF LOCAL GOVERNMENT FTNA.`ICE 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
-®) �1 o�
benefit and to provide additional ipt confidential and can onN be aaessed by Butz gone wwty of b ials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
MAY 4 2011 Taxpayer Name Location Address
C. .n Freeman, Randall G/Na/
993 W 1200 S
---_- ----GIBSON•COUNT.Y AUDITOR. , -______
. - _ - _-- __ - IiAUBSTADT-IN.47639 - ..
9808
Randall G,Nancy JFreeman
11/1 OilIIII I .1110111£fll111111111/ill i1_II_InII mil/ luuuulll[IlltUtu1
993 W 1200 S .
Haubstadt IN 47639-8727
I'Illi'1'I'III'Il'lilllll'Ilil'I'Illlllil'lIl'I"Illlllllli"Ili State Parcel Number Legal Description
26-22-13-200-000.329-024 PT NW NE 13 4 11 7.544 AC
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.
-r .)--_..--..--_-___ti —___-_,_PAR_T2:-TAS.PAYERl_1FQR{t_IATIO\--_-- ---
Ov... First Middle --_^— - .- . Last - -
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Mailing Address(number and street city,state,and ZIP code) Er Same as property address
q(0 4 12 c S \-a q`cC93c
Social Security Number(last 5 digits) Driver's LicenscfState ID Numb& (last 5 digits) Other(please specify in Part 4 below)
aIsI' t Ita I I to o lk IS x li+ sit
Spouse First Middle Last
1468\C4 \ . Vie- t<egiMIdM .
Mailing Address(Number and street,city,state,and ZIP code) ' Er Same as property address
SC w \ZOO ' �o4r t Sck H11oc
Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) ' Other(please specify in Part 4 below) c
arI / I R I J I s . ' 10171 I ? It-k S=
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 or back taxes and substantial financial penalties.
Date Telephone (QA7 it.6 _U1015 3
71/4 . jyteArvtd,ii tore Date Telephone
S l-il (ii a ) 76, F-6653
FOAM HC 10 7979
HescriDM By Slate BoarO ol �Tax Commissianers
To & Filed in Dupliwte
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19�
,(We) � , �
rvlarch, 19 I, (We) occupied as our principal place of i
which a Homestead Property Tax Credit is hereby being c
I, (We) �owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description
Taxing District f6iEy; �ewrr,
Parcel Number
If buying Ofl contract: Owners name ��� simv�e owner�
INSTRUCTIONS
certify that on the 1st day of
' e the following described real property for
r�ed:�G —0�/3 0�� GY3d•�o�4-Qo7�i
4e � - �a ..3029- oa
Township
or legal description shown on tax statement:
�—�E%s� i.3—�—i/ ,5-� 9�.�
Contract recorded in Recorders Office - Record No. ' Page
If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that
structure is used to produce income, describe the use and portion of the property utilized to produce income
Any other counties in which individual owns or is buying real property: County
' hereby certify the above
�'-�,,,.�ov g -�
is true, correct and complete.
Township
am Lo
V /
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immediately
surrounding residential improvements
Other Land \ � � � � �
Total Land
Residential Improvements Dwelling
��� � � j979 Garaqe
�/L�u� Total
Other Improveme s �; ' �
//� AUDITOR
T ' ' Improvements - "Line (6) plus (7) equals (8)
i'�sby cerli y e above is true. correct. and complete.
/ � / n �.
—Sigriaiure ot Asxsw�� - -� — �� —
True Cash
Value
� i � S� o
(2) S3 0
(s) / � 3 O
(4) . %/ S�
cs) ��' °
(6) 7730
(�) /�3P�
�g� 9s 6 0
Assessed
Valuation
/70
,ZqD,�B..
Homestead
Valuation
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�5 = -Z i — 7 9
Date _ .
Date: �