HomeMy WebLinkAboutHomestead_Warner STATE FORM 53569(R'_5-09) TREASURER.rORM TS 1XI
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1-_1_2-H.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 )
liauses higher tax bills for all; therefore, HEA 1344-2099 requires taxpayers who receive the homestead /k
s andard 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 1
19_
,
will be kept confidential and can only be accessed by authorized county officials. The Department of Local' 1f
Government Finance will use this information to create tools that will help county officials eliminate i#
homestead fraud.
,, PARTI?PROPERTY INFORMATION -
Tawaser Name Property Address State Parcel Number Legal Description:
Sheridan D/ RI Box 276 26-23-18-100-001.069-024 004-01069-00 PT SW NW 184 10
Warner Haubstadt IN 47639 �/ .88 AC
Complete and return to: /�
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 -
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 Signature Date
PART 4:ADDITIONAL INFORMATION
•
•
FOftM HC 10 1979
PreuriCeE By State Boa�a oi iaR tommissioners
io Be FileE in o�v��caie
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19��
SEE BACK FOR FILING INSTRUCTIONS
��we)�L���M�% �o��� �x• � ���certify that on the 1st day of
,vlarch, 19�, I, ( e) occupied as our principal place o eside ce the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneticial intefest in the taxpayer
Property Description i
Taxing District (�''�—Tewr�, Township):
Parcel Number
Ii buying on contract: Owners
DO �- 4/D��- 00
Township
� j' � or legal description shown on tax statement:
Contract recorded in Recorders Office - Record N
e
. �2c,�
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 ove statement is true, correct and complete
��_ ) / � r-� �� _
SUeet AOdress
Township
Giry. $�ate dntl Zip (Jpdp
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 � g � � �
Total Land 1
Residential Improvements Dw�ng
JUN 12 i979 Gara9e
True Cash
Value
(i) S—o �7
(z) �
(3) S`d O
�4� � z9� o
cs>
C,��"%. �p,,� Tota� (61 � 7 9 i �
Other Improvements ���'�"""�'�'w (�) �° a �
AUDITOR
T- ,� Improvements - Line (6) plus (7) equals (8) �8) / � S % o
i�eby ce� the above is„true. correct. and complete.
Signamre ol
- ACTION BY AUDITOR -
Approved: ���,��.�e��
Assessed
Valuation
��
/
�j�jjjj�j/
�/���j�
i �
.�
Homestead
Valuation
--'_' %%%%%%%%%/�%/
. -. I
Date: _l�/_�-7__�_�