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Homestead_Holder STATE FORM MOON/S-I0) TREASIA IP FORM TS-IA w APPROVED BY STATE BOARD OF ACCOUNTS.2089 PRESCRIBED BY DIEOFPARTMEWI OF LOAM.CAVFA\MENT FINANCE IC 6-1.1-222.1 Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 101 N. Main Street individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes Princeton, IN 47670 '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 standard deduction to verify that they are eligible to receive the FTbenefit and to provide additional identifying information necessary to allow county government to better monitor homestead 1 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. JUN 22 2011 PART 1: PROPERTY INFORMATION - Taxpayer Name Location Address C. .1`Ant.,- Holder, Gerald W/Janet E GIBSON COUNTY AUDITOR 5E3wwARNOCKST PRINCETON IN 47670 304 1 • Gerald W/Janet E Holder II I 11ii III III I i/II0milli hII1IIIlcli1I911:1111�IDr11111 IDssss111011 till 1030 N Embree ST Princeton IN 47670-8320 '1"I'll lll1'1III1IIIII1I"IIIII'Il 'IIII'IlIlIlllllIlIll'II'Ill State Parcel Number Legal Description 26-11-01-403-003.008-028✓PARKVIEW TRACT 4 1-2,11 1.3664 AC This form MUST be returned to County Auditor's office. Please do NOT send this form back with your tax payment to the county treasurer. r • PART 2:TAXPAYER INFORMATION 0'. I First Middle Last Mailing Address(number and street,city,state,and ZIP code) {� Same as property address ) U n ✓ i • (- inbr'e� • 1 C1VleP n1 IA/ "7(A -7o . ' Spouse - First Middle I '- Last '�CtVI P_A- E , 1—at91 C�2r 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 . ei � d��•, CLAIM FOR HOMESTEAD PROPERTY TAX ::�"" �; � CREDIT/STANDARD DEDUCTION � • ' State Form 5473 (R2/1-90) INSTRUCTIONS; See reverse side �or liling �nstructions. �.' CERTIFICATION STATEMENT �.�..�> r;l�� � 0 G/.�9/9U a�9-J3oog 2.7oAL FORM YEAR HC10 O f E ,.. c C/ aNe) 4 A rY �� � L�_certify that on the 1 st day of March , 19 / �vJe) occupied as our principa lace of residence the f lowing described real property for which a Homestead �operty Tax Credit is hereby claimed: �I (We) owned ❑ Are buying under contract � Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying it under a contract. i, If buying on contract, Recorder's office where If any portion of the ture is.u�ed to prod recorded CONTRACT RECORDED PROPERTY DESCRIPTION 'Township � , ;Legal Descripiion Record Number town, � structure or the land not exceeding one (1) acre that immediately surrounds thai struc- � describe the use and portion of the property utilized to produce income. PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES '�"�'��AUDI�EO�S Land noi exceeding 1(one) acre imme� surrounding resideniial improvements Other land Total land - line (7) plus line (2) � TRUETAXVALUE ASSESSEDVALUE HOMESTEADVALUE ��) (2) Residential improvements Dwelling (4) Garage (5) Other improvements . (6) Total improvements - line (4) through line (6) (7) Total value - line (3) plus line (.7) (8) I hereby certify the above is true, correct, and complete ^' 1989 Pay 1990 Lesser of 7/2 Homesiead Valuation or $2,500 Signature of Auditor STANDARD DEDUCTION ALLOWANCE 1990 Pay 1991 Lesser of 1/2 Homestead ! i Valuation or �2,000 � NON-RESIDENTIAL '- VALUE 1991 Pay 1992 19 — Pay 19 — Lesser of 1/2 Homestead Lesser of 1/2 Homesiead Valuation or $1,500 Valuation or $1,500 %�.