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Homestead_Silva STATE FORM 53569(RILE-10) TREASURER FORM TS-IA APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1.22-RI IMPORTANT NOTICE TiHOMESTEAD-PROPERTY OWNERS Individuals and married couples are limited to one homestead standard deduction. As the receipt of this ction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud uses 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. PART': PROPER Y :'FORMATION .' " Tasnaver Same Prooerly Address Slate Parcel Number Legal Deserintion: Joseph C Silva 726 E SR 68 26-23-05-300-000.859-024 W W 5 4 10 .4132 AC HAUBSTADT IN 47639 Complete and return to: 111111101111111100 111111 R Om©MfNIOINERI© GIBSON COUNTY AUDITOR,101 N MAIN PRINCETON IN 47670 - . PART 2:-TAXPAYER LNFOR1iATION • .. ° . Owner I V nS E h First C IL�LM S Middle (Y LLV� last Railing Address(number and street city.state and ZIP code) (-Same as property address /s,1V\) le), G Jra_u Rd (aX(. � 6sr L-t :_fin s--, / I ._ Middle 6 LL v .Last Mating Address(punter and street.city,state and ZIP code) same as property address • . - PART 3: CERTIFICATION 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 Date 7. PART 4: ADDITIONAL INFORMATION - • ik ■ 4�$i�)E � (4 �i � � � :;a ;.�:=': CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION � . - State Form Sa73 (fi2 / 5-e2) � INSTRUCTIONS: See reverse side /or (iling instructions. C' ! �.� ■ � .�� MAR 15 2001 CERTIFICATION STATEMENT � I �e) c N(��«i, ni R I(We) occupied a ur principal lace of residence the fotiowing de 'bed real property for which a Homesiead Property Tax Credit is ere�y�l8i ed: ❑ I(We) owne ❑ Are buying under contract � �. " ❑ Have a beneficial interest in the entiry ihai is liable for the property taxes on the property and that owns the property or is buying under a contract. - CONTRACTRECORDED � It buying an conVaa, Fee Simple ovmefs name Recordels oKCe where contract is recorded Record num6er Page PROPERTY DESCRIPTION Counry Township - Tarzing tlistrict (ciry, mwn, rownsAip) P I num r Legal description � og� l� �J 5- � i o � �3a ►�� If any pwtion of ihe residential SWCNre or the land not exceeding one (7) acre that immetliatey surtaunQS ihat sWCture is used to protluce income, tlescribe ihe use and portion of Ne properry uulized to proEuce income. - -0�-�300- . �a 9 oa� PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES � Counry Township Counry Township Signature of claimam ereby certify the above statements are true, correct and complete. � Adtlress (number and street, ciry, stafe, ZIP code) ASSESSOR USE ONLY �UE TAX ASSESSED HOMESTEAD NON-RESIDENTIAI VALUE VALUE VALUE VALUE Land not ezceeding t(one) acre immediately (�) . - surrounding residenfial improvements. Otherland (2) Total land (line 7 plus line 2) (3) Dwelling (4) Resideniial improvements Garage (5) . Other improvements (6) Total improvemenis (line 4 fhrough line 6) (7) Total value (line 3 plus line 7) (8) . I hereby certify the above is true, cortect, and Sgnamre ot Assewr Date signed complete. Verifying action - Signamre of Autlitor Date signed STANDARD DEDUCTION ALLOWANCE 19_ Pay 19 _ Lesser of 1/2 Homestead 5 Valuation or S2,000 Signature of Auditw Date signetl c � v � �'