Homestead_Maurer STATE FORM 53569(R1B-I0) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOINrS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE ICS-1.1"_-8.1
5. IMPORTANT NOTICE TO HOMESTEAD:PROPERTY OWNERS:Mani
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
reduction 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
standard 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.
wC *L ?ART!: PROPERTY'INFORMATION
Tasoaser Name property Addrem State Parcel Number J.ecal Description:
Chad M/Kimberly NJ Maurer 2008 TAYLOR AVE 26-12-08-204-000.920-028 DIKE ENLG OUTLOT 13 A PT/13 P"
PRINCETON IN 47670
Complete and return to: ICillir3 ill HEMMED Ell
i�riiii�wii
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
-"- "te. f' • PART2: TAXPAYER.INFORMATION: " 4:� rSt:f1
Chimer
C41 First g7// ,I `� Middle gi last
Mailing Address(number and street.ay,state and ZIP code) ��/�
Same a�poce gym address /7
oRoo ( 2r y to r ire /-'/%7G o,� Z • / 74 70
bppuse First Middle Last
Mailing Address(number and street, ty,state and ZIP code)
/� C� Same as pe0ceny address
?ooB ?/vi 4e 1?-7ncev' `/7e 7v
_
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 Sigbatur /a _ Date
,:`,
FILED
JAN 0:8.2013
GIBSON COUR
'i �'"` ��"" ° CLAIM FOR HOMESTEAD PROPERTY TAX
�� CREDIT/STANDARD DEDUCTION
� �'� State Fortn 5473 (R2 / 5�92)
'> ._, �
e
INSTRUCTfONS: See reverse side for liling insWCtions. �
FORM.
HC70
YEAR
CERTIFICATION STATEMENT -
I(We) ? un t�� , C.. ,! LL � certify th n�t y of
I(We) occupied as our principel place of residence the following descnbed real property tor which a Homestead Prop� e is r�l � .
❑ I(We) owned ❑ Are buying under contract - n�1 i�
❑ Have a beneficial interest in ihe eniiry that is liable for the property laxes on the property and thai owns the property or is�b�n�,uRaet atbn�to a.
CONTRACTRECORDED
If buying on contract, Fee Simple ownefs name G�BSON COl)NTY
Recorders office where conVad is recorded Record number Page
PROPERTY DESCRIP N '
County /, � Township �//A ' � TamgG � �jry,fo��hip)
c ^r /V
Parce �umher Legal description
m/ - 00 lo-Oo
II any ponion of �he residential structure or the land not exceeding one (1) acre t�ai immetliatey surrountls that struc[ure is used to produce ixome, describe ihe use and portion of
Ne properry utitizetl ro produce income.
� PROPERTV OWNED BV CIAIMANT IN OTHER COUNTRIES
Counry Township Counry _ Township
Sgnature f Gavn ni
. ereby certity the above statements are true, correct and complete.
Atltlress (number and treet, ci , slate, ZIP codeJ _ �
(�0 7(c 0
ASSES OR USE ONLY TRUETAX ASSESSED HOMESTEAD � NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediatety (�� �
surrounding resideniial improvements.
Oiherland (2)
Total land (line 1 plus line 2) (3)
Dwelling (4)
Residential improvemenis
Garage (5)
Other improvements (6)
Total improvemenis (line 4 th�ough line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true, cortect, and Signamre ot nssesor oate signea
complete.
Verifying ac6on - Sig�ture of Auditor Date signed
� STANDARD DEDUCTION ALLOWANCE
L
19 Pay 19 _
Les r f ti mestead $
alu ion o 52.000
Signature of Auditor Date signetl
/2-/—m d