HomeMy WebLinkAboutHomestead_Greubel STATE FORM 53549(R3/6-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OFACCOUYIS.201 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC 61.1-22A.I
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPER'IT O\' ERS
• 101 N. Main Street Individuals and married couples are limited'to one homestead standard deduction.As the receipt of this deduction becomes
I Princeton, IN 47670 more beneficial,there is more incentive than evef for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
r HEA 1344-2009 and to provide ovide additional taxpayers who receive the anon ece standard allow deduction to verify that they are eligible
ni monitor homestead
the
® benefit and to prmide additional identifivug information necessary to allow cowry government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
banal Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
APR 1 1 2011
Taxpayer Name Location Address
c. .pfv$.� Greubel, Martha J
v w\ 1145 1ST AVE
GIBSON COUNTY AUDITOR HAUBSTADT IN 47639
8412 -
Martha J Greubel IIDIDIII VIII II I mil 11 111 III II III II ii 1111110.. HI mill II I 11101
Po Box 51
Haubstadt IN 47639-0051
Irtltllrllllllltll1lllllttllllrlllllI'IIII111'I'Illlll"I111111'I State Parcel Number Legal Description
26-19-31-304-000.132-009 PT SW 31-3-10.301 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.
. °-( ..-__-__`__- _____ __--__'._P_ART_2: TA\PAYER1NF_ORlLATIO\------ _ _—_- ,- __ ------ -- -----_
First - . Middle Last
' `/YI/1-2—rit A ,TEA-,c/ a 2 E U s cL
Mailing Address(number and street,city,state,and ZIP code) Same as property address
Pa. 13 o / S/ �A-uB57A-OT, ZV 476 37
°
Spouse First Middle last
— �I- ..---1------------- .
-
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
1 I l l
- I I I - � I - 1 site
PART 3: CERTIFICATION
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and•dorrect 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
FORM HC 10 1979 / To Be Filed in Duplicate
/ '/