HomeMy WebLinkAboutHomestead_Rodgers STATE FORM 53569(R3/5-ID) TREASURER FORM TS-IA
APPRO.'ED BY.STgi:E BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.1-22-8.1
woe_ ''IMPORTANT NOTICEfi,TO HOMES,1EADPSOPERT1''OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
reduction becomes 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 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.
i sA�4 r a z m. s'EcePA'; I: PROPS• 1 ;INFORMA_ ION, -, tu;.
inflater Name Property Address State Parcel Number Leal Description:
Kathy D Rodgers 661 E EISENHOWER LN 26-19-32-101-001385-024 MACK CURTIS 25 PT/26
HAUBSTADT IN 47639
Complete and return to: IMIIMIEMIIIIEHIM1131111111111111ETHOODIRM
y�y .GyIBBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
-t` t ",1112ra+ ;rleiae°•itiv + , c . t • • u , • k -
Owner 1 First ��nn Middle Last
i tn ,&LA ` 6 -e_�
MaiWp Address Der and street,city,state and ZIP code) Same as property adtlress
b(b £ ye4 k.oer Lnn , fi-eulaS4zIE
".)
Spouse First Middle Last
Mailing Address(number and street,city,state and ZIP code) I I Same as property address
Social Secunty Number(last 5 digits) Drivers License/State ID Number(last 5 digits) State Other(please specify in Pan 4 below)
?- «' ^sp ,PART4CERTIFIGATI0N,."
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 Signs Date
_
3PART 3 ADDITIO ._, , , ,_,_�,�__ -
•
n
�%� .
°a CLAIM FOR HOMESTEAD PROPERTY TAX
,��'= CREDIT/STANDARD DEDUCTION . :
�;� State Form 5473 (R2 / 592)
�au .
INSTRUCTIONS: See reverse side lor Iiling instructions.
1� `1. Un
�— _ _ . _ ' CFRTIFICCTInN
FORM YEAR
1
.a' •
MaY n � 1991 �
IIWe) � � V - c ify.ihat �WII9Rtd'79_
��.occupied as our prin pal place of resi nce the follovring described real properry for which a Home roperty?, ewC"rLdR'�6�y Gaimed:
U I(We) owned ❑ Are buying under coniract �. : . � .
❑ Have a beneticial inierest in the entity ihat is liable for the property taxes on ihe property and thai owns ihe property or is buying under a contract..
- CONTRACTRECORDED • � - � . �
It buying on Contracl. Fee Simple owner's name � . . . � � -. �
Recorders oHice where contract is remrtletl , Record number Paqe
. �
' PROPERTY DESCRIPTION '
Township Taxing disiric�jy
A
Parcel number Legal descriptio .
��-c� �3�s--oa �,��' I� • ,t.�-�'�� s as P+
If any portion ot the residential strucmre or �he IaM not exceetling one (t) acre that immediatey surrounds that struciure is used to prod
of the pmperty ufilized to produce income. . ,
��-/9 v3�3-/0�-�/. 3�s-6�� �
PROPERTY OWNED BY CIAIMAM IN OTMER COUNTIES
�eby certify the above statemenis are tme, correci and complete.
Adtlress (number and streeL ciry. state. ZIP code) , ,
��, describe Ihe use antl portion
ASSESSOR USE ONLY TRUETAX �ASSESSED HOMESTEAD NON-RESIDENTIAL
. VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediatety ,
surrounding residential improvements. (�) �
Oiherland (p) �
Total land (line 7 plus line 2� (3) �
Dwelling (4) � � -
Residential improvemenis
Garage (5)
^�
Oiher improvements (6) ' �
Total improvemenis (line 4 through line 6� (7) �
Total value (line 3 pl�s line 7� (g)
I hereby Certify ihe above i5 irue, correci, and Signature of Assessor Date signed
complete.
�tyirg action - Signature of Audiror Date signed
. � � � . � STANDARD DEDUCTION ALLOWANCE � - �
19_Pay19_ .
Lesser of 7/2 Homesiead
Valuation or $2,000 � �
n ureofAudit Date�signetl
5-9-5'7
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