Homestead_Sherman STATE FORM 5359(R)/5-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1"2-5.1
IMPOI '4 AN NO I « �p0 HOOM S AP ' RO ' ' '4 YOWNE�° S
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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
•auses 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: PR o P .RT1 1 FORMAT'el - - -,
Taxpayer Name Property Address State Parcel Number Lmal Description:
Art Sherman 1002 S STORMONT ST 26-12-18-202-001.386-028 5S ADD 342
PRINCETON To/LED
Complete and return to 99 �Q ID1111i1111111I11]llhItID1]DhII1I1l!!]D 111111��lfl1ffill Ill
GIBSON COUNTY W,11301 N MAIN PRINCETON IN 47670
4,,,,i
. BAski:..4f�i AWIER IN. F,ORMATIION • - ,
Owner First GIBSON COUNTY • I • • - Middle Last
111i C.)-te l l Lea_ unarms n
Mailing Address(number and street,city,state and ZIP code) >FCSame as property address
a 111■ First■ Middle Last
I� A . 5h& ►`Man
Matting Address(number and street,city,state and ZIP code) 55—C Same as property address
PAR € GERI IFICA ION -
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
•/'
PARTS ADDITIONAL INFORMATION .
�* k CLAIM FOR HOMESTEAD PROPERTYTAX
' ' CREDIT/STANDARD DEDUCTION
'� f State Form 5473 (Ra / 8-00) .
INS7RUCTIONS: See reverse side �or filirg ins6uc6ons.
FORM n' Y R
HC10 ��� O G�
Counry Tpvnsldp Taing tlisU� (cit}; t , ow�lshiP
ar mber, • `0 . LegaldescripGon . ; - /
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If any portion al Ne residential sWCture w the land rrot exceetling me (7) acre Nai immeCiately surrouMS Nat sVUCture is used to produce income, Eescribe the use and porUm
of the property utilizeA lo pro0uce incame. � - . .
I hereby certify.the above statements are We, corred and complete. .
Land not exceeding 1(one) acre'unmediatety
surtounding residential improvements.
Oiherland
Tdal land (line 1 plus line 2)
Dwelling
Residen[ial improvements
Garage
Other improvements
Tctal improvemenLS Qine 4 through Gne �i
Total value (Gne 3 pl�s !'uie �
I hereby certify the above is We, coReG, and
complete.
Veifying adion - Signature oflwtliror
(�)
(2)
(3)
(4)
(5)
(6)
i�1
i8)
SignaNre of 0.ssessor
�
Date signed
Date signed
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