Homestead_Allen (6) STATE FORM 53569(8318-10) - TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1-22-E.I
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
_deduction 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.
z u. ;PARTI PROPERTY:INFORMATION •• ,t'� >z,^
Taxpayer Name Property Address State Parcel Number J.eeal Description:
Brian K Allen 203 W WILLIAMS ST 26-18-13-402-000.325-026 SYMONDS ENLG 206 PT/207 PT
FT BRANCH IN 47648
Complete and return to: im v r.rmm� n r r pct t:�,s
�ulliiGl1lls��u�uGu�lii>iuii`�a1GuelG��jwaJllilii
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2:TAXPAYER INFORMATION • ate„ 2
Owner t First J Middle Last
f!GM/ Jteltt /eA-1
Mating Address(number and street,city, tate and ZIP code) Same as property address
MiOdle Last
fSQ4 po,, fre �}-(le,✓
ago Mg Address(comber and meet,city,state and ZIP e) ame as property address
T_ I.QL �.�-. -.' s _rr_--;y� .
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 t Sig -ture Date
FILED
FEB 6 2013
G'BSQ"I CQ"MTY MJDIT-
r
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
Sista Fortn 5473 (R614-03)
PteacribeO by Ihe Department ot Local Govemment Finance
INSTRUCTIONS: See reverse side for filing instnxtions.
. �� Oq M� �Y,EAR
H �0 � �j y �
� L°' J
MAR 0 S 2007
� n"'el —�T� l��Q��1 �� �,�J� x_Y V). ��J ceniry thatcof�ha��tsldajdof'N�arOb�,�$9�
I(VJey@ccupied as our pnnrapal place of residence lhe following described real property for which a Homestead Property Tac Credit is hereby daimed:
�. / /
Ly� -fCA�e) owned ❑!ve buying under contract
� Have a benefidal inferest in ihe enfity that is liable (or ihe properry taxes on the properry and Ihat owns the property or is buying under a wnVaU.
II buying on contraq, Fee Simple owners name
Recoidefs ofice where wniraq is remrded
Counry
7uvnship
Tacing
Ihe oroneM in
Record number � Paga
— W� �� I� oPeM U MoWe Homo (l.c. b7.7-� .
H any poAion of Ne residenllal struGure w Me ax p one (1) aue lhat immediately wrtounds Ihat sw re is used to produce income, describe the usa and portbn
ot �he propery util¢.ed to produce inmma. �
w-�8-/3 -vo� -o�.3�t5-o�lP a� �,� a� -� �'
CouNy
County
I hereby certify the above statements are We, correq and complete.
imberendstreet, ciry,�s�ta. Z1Pcode)
Signature W A�Wrt«
20 _ Pay 20 _
Le;;er of 1/2 Homestead
ValuaUOn or E35.000
S
Date sipned
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