HomeMy WebLinkAboutHomestead_Metcalf STATE FORM 53569(R3/5-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.3009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-r.1-22-8.1
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
(pauses 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.
. PART1: PROPER Y INFOR,IIA ION . .•
Tower Name Promos'Address State Parcel Number Legal Description:
Michael D Metcalf 4060 E VALLEY PASS 26-23-11-200-002.170-024 WHISPERING WINDS SEC 3 LOT
HAUBSTADT IN 47639 15
Complete and return to: lilt 1100][11MEN O]MIDIDII 1ll0OIW1��m�®
- GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 111001
PART 2:TAXPAYER INFORMATION _
Owner] t First 5 Middle Last
IC I\ 1 (L)r\ a � e n n LS e:± C0. 1 -F
Mang Address(nunter and street,dry. tate and ZIP code) I Sa a VopertY dr
40 (00 E
First Middle Last
e17borah Mario M P1e, al
Mating Address(number and street,city,state and ZIP code)
[y...1.Same as property 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 1 SW -ure Date
• V` PART 4: ADDITIONAL INFORMATION
•
• /
�;. CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
♦ / State Fwm 5473 (R614-03;
Prescnbetl by the Depanment of Local Govemment Finance
INSTRUCTIONS: See revc�sc sfde Ior liling fnslruclinn::.
FORM �` YEAR
HC10 �
::,J6- -�i �".s`. r . .:.,,'_' ..;., _...,.._a:;_ ._. �:.l:tR11hIGA ONST TEMENT�: :_.- - � . ,._...., .
I(We) certify that on the tsl day ot March, 20_
I(We) occupied as our principal place ot resi nce the Ilowing desu real property for which a Homestead Property T�c Credil is hereby daimed:
❑ I(YVe) owned ❑ Are buying under wnlracl
, Have a benefidal interest in the entity that is liable for ihe property taxes on Ihe property and [hat owns ihe property or is buying untler a convaU.
. ��
�r�=e�'t"x.i�c..?p'''t x.-.��. ,.. .h�->_'.- . �.�-:,n_.':�..:` CONTRACPRECORDEU='__ �.,..., . .. ._. . : e...:�:i..:' '
. ._., ��?'� � �
I( buying on contract, Fee Simple owners name
Remrdefs olfite where conVad is recor0ed
l
Tavnship
resiEential sWCture w the Wnd not
�d to produca i me.
����%O-oo
G
acre
Ta�ing Aistricl
surtountls
Record numUer � Page
. .. � . � - .. . -'.�` .. . . . . �
question:
ieal property ❑ Alobile Hamo (LC. 61J-7)
re is uxd to produce income, desuibe the use and portion
�a$:'�:'a. .-�+��:�'.`� �-.n�..� - "�':' :PROBERTY.OWNED��BYCLAIMANT�IN�ATHER"COUNTIES�=� - ��ek -xj,-�=':�n� -
Counly Toanship County • Tavnship
I hereby certify lhe above statements are irue, cortect and complete. � aw o( claimant
_ �
Add s �numbei anC strae�, ciry, sfafe, ZlPcode) /\
�. 39 `�
�"'�s�° F�+ ��+'';�� � �' ! � � '- . TRUETAX ASSESSED VALUE � NOMESTEAD'' NON-RESIDENTIAL.
:, ,
,vq x�'i� � -ASSESSOR�USEONLY:, . . • - - - _., - .
�s,�t�f{�,+4i.....7.A v.h;:a,-=. . - ' VALUE AT100%OF.TTV . � VALUE ..45i:VALUE. - ..
Land nol exceeding 1(one) acre immediatery - -- - � .
surrounding resitlential improvements. ��� . -. � ' , �
Otherland (p) - � _ - -
Tcial land (line 1 plus line 2) (3) I
Dwelling (4) . •" ..:" . �- -
ResidenGal improvements or Mnually . : : `��`'`,'}"�' :"' �"''' �
Assessed Mobile I Manufacnued Hwne �-,"v.{���.'"��:: �-:�• _ ..
Garage �5) - ' - `' .
Other improvements (6) I
Tdal improvemenis Qine 4 fhrough line 6) (��
Tdal value (line 3 phs line � �g�
I hereby certify Ihe above is W e, correct, and Signawre of Acsessor Date sgnetl
complete.
Vetifying aclion - SignaWre of Andi�or Dale signed
- _ -� = -.-.STANDARD.DEDUCTIONALLOWANCE-� � � � � -
20 _ Pay 20
Lesser of 1�2 Homes:ead
vauauon or 535.000
5
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