Homestead_Hensley (6) STATE FORM 53569(R3/S-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS, PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.1-2251
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 all auses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
st 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
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.
- PARTI: PROPERTY LNFORNIA ION
Taxpayer Name Property Address Slate Parcel Number Len!Description: -
Leonard Paul/Hensley 504«'EMERSON ST 26-12-07-103-001.172-028 PT NW 7 2 10 1.00 AC
PRINCETON IN 47670 I�I7III I�fr 1�fBg I�I111flI �A
Complete and return to: IIIfhIDll7DEni ffl fl Wa�fILll1111FWJI lllE ®
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 !4 nil
PART 2:TAXPAYER INFORMATION
Owner 1 ) First n I Middle Last
„`-e0 rti)�Ir rA v ��� c /4) S lei/
Mailing Address(punter and street,city.stale and ZIP code) I r I”"'as property address
- .
-'�/' First - • Middle Last
COAI�/6 3u NNews /z- )
Mailing Address(number and street city.state and ZIP code) �J I Same as property address
50V WEST _ I-11 er•aa M 4/4er7oN -TA q76 70
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 ture Date
PART 4:ADDITIONAL LNFORM<1'IO)ti? 1, ):
•
t l or -•
•
pc C 3.1.2012, .
GlBSON COUNTY AVp1TOR
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SEE I3ACK FOR FILIhlG lidSTRUCTIOhIS
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� are 1�uyirxi wrier co�itract
� have a i�lie�icial iti�erest in ttie ta=;oayer
Fro�_rty L»scrip`ion_ in �_�v� �iu�ty 1 na�c��,v� 'Zc�::,�:
'1'a::inq Uistrict (City, Tam, 'i'o:arslup) :
Fe.rc°1 ilu�nt�r or legal description si;rsrai on ta� st;at�r�it:
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Co,lc.ract recorued iii I'e�rcler's Office - IZ^cord ti�. Yaye
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u�� pro�rty utilizecl '� produc° itror�e
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�h/�'�r�1�� c°�tify �l�e ,�'}•-^,-�,�� s�at���nt is true, �rr�t ard ca«g�l�t�.
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surrourdv�g residential iur�rov6mnts
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� l�sea� certify ��e �:p is true, correct, ar_7 mm�l_t�
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