HomeMy WebLinkAboutHomestead_Gray (2) STATE FORM 53500(RI/&10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PREscnrnro BY 111E DEPARTMENT OF LOC.A1.00VORNMENT FINANCE IC 6-1.1-214.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
..,,yy1001nn,N..Main Street
fl Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
r-'-, ` more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
L ,L■ 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
q filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
APR 7 2011 Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
C-�- Taxpayer Name Location Address
Gray,Jeffrey D/Cynihia 1
GIBBON COUNTY AUDITOR
100 S
HAUBSTADT1 1655E 2
IN 47639
11468
-
Jeffrey DGray
milI iii:IIII:1110111[III1if!!110011011011011J1101OH 01111011010110111101011111
1655E1200S
Haubstadt IN 47639-8047 -
Iltltlllullllnilllll"IlrllllllrllJlluluhl111111'I'll'lll1l State Parcel Number Legal Description
26-23-16-100-002.012,024/PT NW NW 16 410 2.553 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.
— — — PART 2:T XP Y R INFORNIATIO\
ON. .. 1 First Middle --- Last
TEFFR�Y [7A LC ( €A-y
Mailing Address(number and street,city,state,and ZIP code) 'Same as property address
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-
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 iaxes and substantial financial penalties. --
Owner� ture Date
0
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
sm� Fo„„ sira rti� � sa�
Rea+bed by Ihe DepeM�d d L«al Gmierrmad Franm
wsraucnoros: s� �re� �a �« ra�y m50-�s.
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FOR�
HC10
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I(V✓e) � � 'F ���,yC1 l�(�� certifY Nat on the�sidey°bT�Aatd�, 20_
I(VYe) ocaipied as av ' of " ence the To desad�ed r�l poperty id� a Hanes�Rrooatv �t is heleby daimed:
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�� M�e) owrww ❑ are w,yug raa oontraa
Have a benefidal mterest m the entiry that is liade fw the property �ces m Me pioperty afM Ciat owns the pf6'ph�,or�p�ng under a contracL
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It Wy"�p on cmtrac4 Fee Sirt�le o.irera rema
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T�r¢fup Tamg distri7 (riy, I
Legal d�oiptim Is Me pm
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�,e,�iae,sis� s�,m,e o. u�e �o „a �,� ��,� �ve ma�:��ey an,wws uw
EiFmd m am�ce mmne.
, �...: _, . . . �.�_ - .`._.. ♦ ' -x. �. . ,' :' PROPE3tTY OYVNED
Counry Tuvnship
I heieby certiy the above sta�ls are true, corted and carplete.
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coW,ty
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Re�ad numher � Page
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is ueed b piodice'rimne. damibe iha �e and portion
t. ..: ., . + . . r > r ` �.-* TR11E TAX AS� VALUE � F1Q�STEAD' � :,�',., „''��NON-RESID@lil/LL"'�� . � `:
..� �< < i. ASSESSOR USE ONLY _. yt ..• yq�,uE z �.AT,t00X OF TTV n . VALUE rls �� 7t,`..YALUE �w,'�. i. �
�,_(i ..,,iGt. ..: � f ra. , tf k�i. `FJ g „^Y.., . �. . , ? �.+.a.-�, os �} ^Y� ..4X dri�.n�... , t' . . �...,a..:�
tarw rwc ex�dirg i(one) aae imnediaeey � ', + i`� �t`�t 2`•`�I��w ri';" .t6�'�'$ j
a6��
siarpmd'vig residential impovements. �� i ra ��a �es?:, v.eR "ra:`.� � rc�'+'�ssc
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OweRng (4) .[} .,��V•�Yr� �.��G��u'�"� Y��i�:w;� kG'�Z'�T
Resdential'vnprvvernen�s orMrwafly ±.c>a�:?�.,,f j, -�?,..��i�''ti51�
Aases�Alobde/Mamda�tuadFlome � 5 .f"f �Tx��"�'��'"tj�`�hr�.�a
� � � ' n. �.�'�y� 3F��'��,t�C,��,r� , ±�"v r
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OUiei'unpovert�en� �g� ��' ;^,;a�tii.,F•:.,:.
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Tdal uriprwertiertls (!are 4 tluough Bne 6) i7�
Tdel value (I'e/e 3 pGs Gne � (g)
I hereby certify ihe above is hue. cartect. aM SiB�m+e ofAc�aar Dam sig�ed
�mp�te.
Vaifying aaian - Si�ymtie otn.�tor Qete signed
20_Pay20_
Lesser oF 12 Homeslead
Vahiation or f35,000
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ALLOWANCE�<..' . :''.ro,�'.
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