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Homestead_Pierce STATE FORM 55569(R)8.10) TREASURER FORM TS-IA APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE 106-1.1-22-3.I IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS : w. 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 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. PARTI'PROPERTY INFORMATION c.` 't ery .-%;'" , iP. 'Tf Telmer N'amt Pronert•-Address Slate Parcel Number Leoal Description: Terry R Pierce 452 W GLENDALE ST 26-12-06-303-002.174-028 PARK VIEW I PT/2 PT/3/2627 PT PRINCETON IN 47670 [n D^B ILK 2 p ���pn�[I� 17 1!?!E.'IIf Complete and return to: iut1111EI Matti BillJLli©ILII�IWIIJn11taWilil Er1IIBill GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 •d PART 2: TAXPAYER INFORMATION Owner 1 First Middle last TI , 17I��T , Y, RC. �' MatlNg Address L and street c ,state and ZIP code) I Same as nropany address s' d N\ )00A-L 61 P i >7c 06,0,1 7m 19 2‘ 7Z5 Last —rig Gil /219 SUL= Pl L 12GE Mailing Address(number and street city,state and ZIP code) Same as property address �fSp2 lit/. CrLENo fILE Si• PRINCETON 47co70 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 a." ?... • ;_'. PART'S: 1 I // DFC1g ?nt? • // V v lC GIBSON COUNTY AUDITOR iORM NC 10 19i9 NeSCnDeA By Sta1e BoarO of ia� Cammissione�s CLAIM FOR • ,o- ��'�` to Be Fil¢G in Dupli[ate �TEAD PROPERTY TAX CREDIT FOR YEAR 19 � 9 � E BACK FOR FILING INSTRUCTIONS Q�(r- O'1 /�//. �� � � OC 7 �(We) , - certify that on the tst day of �vlarch, 19 � ,(We) occupied as our principal place of residence the fol�owing described real property for which a Homestead Property Tax Credit is hereby being claimed: I, (We) �owned ❑ are buying under contract ❑ have a beneficial inteJest in the taxpayer Property Description in�ae/� :-�-� Taxing District (City, Ta�aa�-�ewaskrp): Parcel Number I y � ..� .. or legai description shown on tax statement: awi- If buying on contract Owners name ��� simole owneq ' ' Contract recorded in Recorders Office - Record No. Paae If any portion of the residential structure or the land, not exceeding one (1) acre that immediateiy surrounds that structure is used to produce income, describe the use and portion of the property utilized to produce income Any other counties in which individual owns or is buying real property: �' hereby certify the above statement is true, correct and complete !`, . _.. . _! . .. n .. County Township Individual either owns or is buying under a contract that provides he is to pay the property taxes on the residence, or has a beneficial interest in the taxpayer. - FOR ASSESSOR'S USE ONLY - 0 i Land not exceeding 1(one) acre immediately surrounding residential improvements Other Land � � � p� � Total Land b Re dential Im rovements s� P Dwellin gi 9 ,. +. ' 1 9 ''�'\� 2 Garage �% ,� /� Total Other Improvements(/i . }`� � T°' '�Improvements - Li �6) plus (/'�q�ualR (8) I�aby certify the above is true. correct. and complete. OI A552550� True Cash Value (�) � Sc (2) '_ — (3) � lc � � �a> S 3 0 (s) � o ^ (6) ��� 0 (�) — ° — (8) �o `��� - ACTION BY AUDITOR - �-z 70 Assessed Homestead . • . . - i � --�_� 1% - - , �j�j/�jjj/ - — jjjjjj��j/ ��jj�j� ����� _L%t- G-,!9-�9 Da�e -�-�C�.°��k) Date: _��-� ��9