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STATE FORM 53500(113 I 8-10) TREASURER FORM TS-1A
APPROVED BY STATE BOARD OF ArmuNr&MA PRESCRIBED BY TIEDEPARTME\T Or LOCA1.001.12NMENT FINANCE IC6-1.1-12 4.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
• Princeton,IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher in bills for all;therefore,
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to receive the
Ill Y benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
1 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.
PART I: PROPERTY INFOIL\IAT ION
MAY 2 2011 Taxpayer Name Location Address
C. .r+` rte Beck,Thomas.J / ,
�C a 8627 Access 850 N
GIBSON COUNTY AUDITOR 1dAZLETON IN 47640
8
Thomas ABeck 11111UII111111II�IfI IIII�IllEllil mllBIflII_F11111_11111 IImmili11 11111
8627 Access 850 N
Hazleton IN 47640-9210 ,
ulllllll"uilllllltlll'llli'1111'I'lll'llli' '1I111IFi111111i1F State Parcel Number -Legal Description
26-02-30-300-000.085-01 /PT LOT 4 301 101.493 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.
I _ PART 2: TAXPAYER INFORMATION
Owne 1 , , : First Middle Last
1 hvo5 ) tuna*hors (11-ecK •
Mailing Address(number and street,city,state,and ZIP cod [ame as property address
5 an N.I. Access vad an N
_ __
PART 3: CERTIFICATION
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 •Id substantial fmancial penalties.
Owner I Signa F; Date
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