Homestead_Friedman • STATE FOAM!3:1411C ‘41.1 - MANRG FORM IS-IA
APPROVED By STATE BOAROOF n!MTR'W.bn PREAAILFD BY TlL DEPARneTOE LOCAL nwERNMR.T FINANCE pre-u-r-1.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples me 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 tat bills for all:therefore.
HEA 1344-?009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recent the
benefit and to provide additional identifying information net-saty to allow county government to better monitor homestead
tiling.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this infomtation to create cools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Properly Address
Friedman,Anna
504 S Eastview
Fort Branch IN 47648
7893
Anna Friedman
504 S Eastview State Parcel Number Legal Description
Fort Branch IN 47648-1606
III I I I I I I I I I I I I I I I I I I I 26-19-19-102-000.596-026 /011-00596-00 CLAR-ENCE TERRACE A 6
to tot ntn uIuse t n tot a unutr n ✓
PART 2:TAXPAYER INFORMATION
Owner I First Middle C f Last
- .
�g Address(number and street,city,state,and ZIP code) _ - Sam res —
e s property adds --
SO 2/ 8, L' QTvi �.u3 S1, � fort rand elf 4( 744( s'
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
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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 eliuible 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 p r Date
( )
PART 4:ADDITIONAL INFORMATION
.p
,, rt,\ CLAIM FOR HOMESTEAD PROPERTY. iAX, ,��' ;
� yJCREDIT/STANDARD DEDUCTION
tiLnc Pwm �.t731R6 / 403� '� ' .•.
Prescnbetl Oy I�e Department ol Local Govemm=nt Finano� '• .- ' `
INSTRUC7fONS: See revcrsc side Io� /ilmq inslnir.linns -' � �
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FORM
' HC10
YEAR
I(VJe) ��� V�/lJ� '`/ /�._XX, / Ylili(JV`� ' � certify that on the 1st day of MarcF�, 20_
I(We) : as our principal piace of residence Ihe following described real property (or which a ert r ereby daimed:
I(We) owned ❑ Are buying under contracl � � �� �� �
� Have a benefidai interest in the entity that is liable for the property taxes on the property and that owns ihe property or is uying under a contracl.
Counry
I! any poNOr, o!:�e resiEential s',mclure ar
of Ne properry util¢ea b protluce income.
Tavnship
district
I Is ihe D�operty in question: �
al property ❑ Mobile Homo Q.C. 67.7-�)
wrrounds that shucWre is used lo produce income, describe Ne uu antl porUon
���t?':."��Y� ��.�:��a�,��`i�.�«:.s�f„r;<.--:��ST/WDARD:DEDUCTION�ALLOWANCE'?:'�.�c,a;.�.-.s�.:�tiz' _"-_- ='�"��':'v?�-�t't'; _
� 20_Pay20_
Lesser of V2 Homestead
' vatuauon or 535.000
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Sgnatureoflwddw " � - - Datesigned