Homestead_Boyd STATE FORM 53569(R3f8-I0) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.1"-8.1
IMPORTANT NOTICE-TO HOMESTEAD PROPERTY OWNERS • .
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
de4uction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
uses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
s andard 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 PROPER Y ,'FORMA ION -
Taxpayer Name Property Address Stare Parcel Number Legal Description:
Mark A Boyd
104 E CLARK ST 26-17-12-202-000.505-022 OLD PLAN 3 E 1/2
OWENSVILLE IN 47665
Complete and return to: I®hIOO]Dllff EIRI]� IRMUQV�000mlllfl®
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
] Jll� LL LL IlJfll
- PART 2:TAXPAYER INFORMATION
•
Owner I First Middle Last
Adi 1qr Mon �nycl
Magog ress(number and street,city,state and ZIP code)
Li
L i Same as property address
PD (bo/C 533 Dwem V II e.Li isA) 7(06 5
_`7}Pplic, „. e /4 n ii &ItCb
Mailing Address(number and t.city.state and ZIP code) Sam as properly address //
Po (�oX 53. I ,a Li /Lip 6
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 I Signature Date
PART 4:ADDITIONAL li\FOR\IATION
AD
PILED
NOV 132012
C..J.IS
GIBSON COUNTY AUDITOR