Homestead_Smith (74) STATE FORM 53669(8318-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.1-22-8.1
I IMPORTANT NOTICE,TO HOMESTEAD'PROPERTY',OWNERSt, .:-.4-€:F;• -
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
®'eduction 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.
• at ;Mrfl -: PAR I: PROPER Y INFORMA- ION r s r te;,; f-r , •??n+,,, 5 s;.:
Tasparer Name rropertY Addres( State Parcel Number Veal Description:
Heber K Smith 504 HOODING AVE 26-12-08-203-003.588-028 DIKE ENLG SEC B 27
PRINCETON IN 47670
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Complete and return to: IBHlI Bin 5 U 1115uB4 11tHSHaH'il IIIHLBEEIi11,i it
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
+' : PART 2: TAXPAYER INFORMATION:. - 'rs ,` a .`)Y.'
Owner 1 First Middle -La51
d,,� eE ,ri S,„ , r,(
Mailing Address(number and street,city,state and ZIP code)
` Same as popery address
So 9.- /1,4Rc1iA)r/ mvL eP/1 c7 nl, X'J 4fX 7Q
spouse First Middle / Last
(14 N E r t z 4,,,ue 53„, , 7/I
Mailing Address(number and street.city,state and ZIP code)
//J� ) T 1 _,r/1 [�-/r
Soy � c• /A17 /I✓L °I NLC'✓N/ I:1 L /6 ^ O Same as popMY address
-
r�e�>.,a ,. -....,:: . ._,. i.—.� �-
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 l g e Date
":
I .1 TT C D
A AJS_I tt
0 NOV 2 Z31L
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GIBBON COUNTY AUDITOR \\`
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