Homestead_Beyerle STATE FORM 53569(R318-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF 1 OCAL GOVER.NME.VJ FINANCE IC6-1.1-22-8.1
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
causes higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
s adard 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.
PA'TI: PROPER Y INFO'MATION
Taxpayer Name Property Address Slate Parcel Number Leal Description:
Paul T Beyerle 507 N BROWNLEE 26-12-07-101-001.681-028 FOREST PARK I9PT/ISPT
PRINCETON IN 47670
Complete and return to: IMl�[17fI�n�7fll��prflffpfl11I111171rtf113110IIt1I l hill llll.
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 G8146t Iff74uGiutll iEn i Jin6N
PART 2:TAXPAYER INFORMATION
First Middle 6 -
Ai .' — /-' e /east
er
Mailing Address(number and street.city,slate and ZIP code)
Sane aspwnry address
5 0-7 6 owN/ ec
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 --'- -lure Date
;<
PART 4: ADDITIONAL LNFORt\I ATION
LAST S di3'13 gTa rdert)! r,"CA/ /'OAJ CA.pp
Nov 7 2012 - -
GIRCnM COUNTY AIIn1TOR
CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
Siate Form 5473 (R6 /4-03)
Presrribed by the Department G Local Govemmenl Finance
/JC`STRUCTIONS: See revcrse side lor7iling instruclions
�V' FORM
HC10
YEAR
��e) certify ihat on � V iyt d��f�, 20_
�I�(W/e) occupied as our principal place of residence (ollmving described real property for which a Homestead Pr erty Tac Credit is ereby daimed:
IO 1(VJe) owned ❑!ve buying under contract
� Have a beneficial interest in lhe entlty thal is liable for the property laxes on Ihe property and Uiat owns the, {���r {� ���
If buyirg om m�Uact. Fee Sunple ownefs name
Recorders ofice where conVact is recorded
County
�i�i°= 0/( $I-00
If any portion ol the fesitlen�al SUUCturB w
ot the property utiized tn produce income.
Covnty
Toxnship
not e:ceeding me (1) aae Nat
Twrnship
I hereby certify the above statements are true, correcl and complele.
stafe,
Land not exceeding 1(one) acre immediately
surrounding residential improvements.
Otherland
TUaI land (line 1 plus line 2)
Dwelling
Residen6al improvemenfs or Mnually
Assessed Mobile I ManufacWred Harre Garage
Other improvements
Tctal improvements (Irne 4 tfirough line 6)
Tdal value (line 3 plts line n
I hereby certify the above is W e, correG, and
complete.
Veii(ying aclion - Sig�aWre of PLtlimr
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TRUE TAX � -
v ��'4VALUE��,�
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(Z)
(3)
(4)
(5)
(6)
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Signature of Assessar
Tazing
Is
of
Record number � Page
propertyin ques on:
eat Droperry ❑ Mobile Homo (I.C. 67.7-7)
Ihat swcture is used b produce inoome. describe ihe use antl ponion
�
signed
signed