Homestead_Beraglia STATE FORM 53569(R2P5-09) M1- TREASURER FORM TS-1 AI
APPROyEDaIY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.I-22-9.I
Y- 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
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uses higher tax bills for all; therefore, HEA 1344-2099 requires taxpayers who receive the homestead
s ndard deduction to verify that they are eligible to receive the benefit and to provide additional identifying
f information necessary to allow county government to better monitor homestead filings. This information
dill 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: . -
PAR 1: PROPE•TY ,'FORMATION -
Tasnarer Name Property Address State Parcel Number Leal Description:
James P Beraglia 406%V Spruce 26-12-07-101-000.486-028 019-00486-00 PT NW 7-2-10 .17 AC
Princeton IN 47670
Complete and return to:
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON LN 47670
PART 2: TAXPAYER INFORMATION . - , - - -.
Owner 1 First Middle lay
i i i / P - ' BEw
Wdbg Address( unter street,aty.state and ZIP code)
VI Sarre as property address
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• .- First - _ • - _Middle '- Last
4' I I
Mating Address(number and street,city.state and ZIP code)
. I Sane 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 taxes and substantial financial penalties.
Owner 1 SgreM , /// Date
. .1 0-i./ PART 4: ADDITIONAL INFORMATION • •
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• _ _ . � . . _AL - . . .
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n
' CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
t / SUte Form 5473 (R6 / 4-03)
� Presaibed by the Oepartmen[ of Local Govemment Financa
INSTRUCTIONS: See ieverse side �or (ling instrvclions.
V�� --------
FORM YEAR
0
JU n g �gg�
I (We) certify thal,oii't6e4sLda'�if.March, 20
I(VJe) i as our principal place of residenc e following describ real property for which a Homeste���r�� Cr d�t is�ereby daimed:
� N�Y AUDITOR
1(VJ ed ❑ Pre buying under contrect
Have a benefidal interest in Ne entiry ihal is liable for ihe property taxes on Ihe property and ihat owns the property or is buying under a contract.
�� buy�ng on conVaq, Fee Simple owneYS name
Recordafs oflice where conVaq is recorded
Racord number
Pege
�+nh /� 7o.mship Tm�ing c1 (ciry, town, fownshiv)
LL.J � 7II��
Parcel number ' / L a desc' tion Is iha property in Question:
�/ ' Q� "t'� � -a -/o -/ % AC eal property ❑ Moblle Homa (/.Q 67J�n
II eny portion of lha residan9al sWUUre or Ne land not exceeding ona (t J acre ihet immediately surtountls that s cture is used to produce income, describe tha use and poNon
ol Ne properry utllized to produce income.
+' \
�
�
of Puditor
20 _ Pay 20 _
Lesser of 7!2 Homestead
Valuation or 535,000
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