Homestead_Harrell STATE FORM 53569(R3B-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.1-22-8.I
"-?INIPORT4NTN OTICE TO HOMESTEAD4'ROPERTY OWNERS ' °:t
..: _ .r ' -. .t. _
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
ak
auses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
• a dard 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
I will be kept confidential and can only be accessed by authorized county officials. The Department of Local
iGovernment Finance will use this information to create tools that will help county officials eliminate
i homestead fraud.
. PAR1`Im PROPERTI I\FOR\1ATION ,;
Taxpayer Name Property Address - State Parcel Number Leta Description:
Robert V Harrell 318 S PRINCE ST 26-12-07-401-002.063-028 PT SE 7-2-10.21 AC
PRINCETON IN 47670
Complete and return to: EIHHlEHHmHIlifHHml1H®OmHn
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
a-PART 2..I'AXPA%ERiNFOILMATION . : 11
Owner I First Middle last
-go35-K I q. 1-1ARee-t_i_
Mailing Address(number and street,city,state and ZIP code) r
I Same as ixWerty address
318 . Iti-N e- S . 1)tu ca -To€0t lid 4-7C070
First Middle Last
jEgrrSR G. j4 feRELL
Mailing Address(number and street.city,state and ZIP code) ['Same as property address
378 6. ?R_nlcr- , 5;. TR-1.4.1tE-rok t &f74,7o
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 /
� CLAIM FOR HOMESTEAD PROPERTY TAX � FORM YEAR
} CREDIT/STANDARD DEDUCTION O HC1a �/
Slate Form 5473 (R61403) \� � /
PreSaibed by l�e Department of Local Govemmeni Finance ("��
INSTRUCTIONS: See reverse side 7or Iiling instruc6au. � 0
�`���,,' "' °�'�r � - - " �. ..: 'tts�. 1:,' 3 1t:CER .ICAiI N�STATEMENT�r` „t _. � '�� `a�s' .
".'�-��c:Y�'��:���.30.���'�.`.k. �r�._..._. . _....._.__ csie�;�a�1v'���r...._.;,.-?�`�='��'h�.�-'��e�,Lv�`�'xi
��e certify that on the 1 st day of March, 20_
I ) occupied as our principal place of residence the td 'ng described real property for ich a Homestead Property T�c Credit is hereby daimed:
I(We) owned ❑ Are buying under contract �
' Have a benefidal inierest in the enEty that is liable for the propeRy taxes on Ihe property and that owns ihe property or is buying under a conVaU.
I( buyim� on coniraq. Fee Simple ownets nama
where contrad is recorde0
County
Parcel number
oi9-Qao�
If any portion Of �he resid
ot the Oroperty utiliieE to
Twvnship
sWCWre w Me Wnd
�t8 i�1CAme.
Record number � Page
'� /ll I ��Real D�opeM O�b��e Homo (/.C. 6/.1-�
acre lhat immetliatety surrounds Na W ciure is used b D�uce inmme, describe tha use and portbn
��.435'E�'i.+�'����,�i�.�.�.-°°",�rrn �;�a4PROP.ERTX;OWN60'!BY:CLAIMAHT;IH,'OTHER"COUIJTIES�°`.�,.'�,,..`�����'��>��A�.�E?i
County Tawnship County , Twvnship
I hereby ceAify the above statements are We, corted and complete. Signature otdaimant
Address (numberaM street, dry, state, ZlPCOde)
-_�"s.�"��i,��_,�a'°�.',�:a^:�P���?�+`�i��,'�t'�,�y�.STANDARU'.DEDUCTION`ALl'OWAMCE .`^_w.�"'y"Y1."i .v��'�'r�"c�._.`'�'t�'"'��,t�.";n'zi�jk�="-
�, �_<
20 _ Pay 20 _
Lesser of 1/2 Homestead
vawaUOn a E35.000
$
Signature of Auditw " Date signed