Homestead_Lederman STATE FORM 53569(R313-10) TREASURER FORM TS-IA
APPROVED BY SATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.1-22-8.1
- IMPORTANT NOTICETO HOMESTEAD PROPERTY OWNERS
. Individuals and married couples are limited to one homestead standard deduction. As the receipt-of this
uction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
d d
auses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
sb. -.1ard 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 INFORATION
•
Taxpayer Name Property Address State Parcel Number Leval Description:
Jaci Lee Romershausen 1D''LANE 26-18-35-100-002.111-024 SUNSET ACRES 6
- -- _ .— - HAUBSTADT IN 47639 - ___ - - _. — — . _ __ —_
Complete and return to: I11111IROJL'BfIII11711!�PIIRl�tn®B�111111181t11m1111171®
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON LN 47670 h 111 W 4J IlC ILII
PART 2c.1 4XPAI'ER INFORMATION .
Owner I First Middle last
L_ Le 61 k r'ma h
MRding Addressss(number and street city,state and bane-code)
1 "3`� �+ou1 h ,)b4 Ida n Imo'^ property address
� u�ns�(i�k7 I. �71r3
W ✓ First ' I� �. � Middle �l�F�'�[�'!-� tav
• LvUV - . -
Each undersigned certifies,under penalty of perjury.that the above and foreaoing 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.
Purer I Signature Date
PART 4i ADDITIONALFOLIA'CION. ., -IN ! .
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