Homestead_Wallis (4)r
spit FORM 5't IR:',API TREASURER FORM TS-IA
APPROVED BY STATE BQ\RDOF'MCOU T..'on FREARIam BY TM DEFAkfleC Of LOI'AE CKIVERNMEA7 FINANCE r.-LI-r4 I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
/.i-y.. more beneficial.there is more incentive than eser for homesead fraud.Homestead fraud causes higher tax bills for all;therefore.
J/ HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to ragas the
benefit and to provide additional identifying information necessary to allow county goemntent to better monitor homestead
filings_This information will be kept contidauial and can only be accessed by authorized county officials.The Depannteol of
Local Government Finance will use this information to create toots that will help canny officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Wallis, Linda K
7965 S Andcro L\
FORT BRANCH IN 47648
2978
Linda K Wallis
7965 S Andee Lane State Parcel Number Legal Description
FORT BRANCH IN 47648-1548
26-19-19-103-001.195-026 SOUTHGATE9
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.
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
LINDA SAY U) ALL �S
•lug Address(number and street,city,state,and ZIP code) Same as property address
`79 (0C S . 4nJ ee LA tit_
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 Pan 4 below)
_ _.. _ see _
• 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 and substantial financial penalties.
Owner I nature Date
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDfT/STANDARD DEDUCTION
Stata Fortn 5173 (R614-03)
Prearn'6ed by Uie Departrnenl d Locel Covmrurimtt Fina�e
� INSTRUCTIONS: See reroein adCa b IYip iy0rucdona
FORM � YEAR
HC10
I�e) v ivUry��Gt o L u4� day of March, 20
I(We) occupied as our prin pa place oi residence the following described real properry for which a Homestead Property Tac Credit is hereby daimed:
❑ I(We) owned ❑ Fve buying under contract �a� �� �
' Have a benefidal inferest in lhe entity Uiat is Iiabie (or the property taxes on Ihe property and Nal owns lhe property or is'buying under a wntraU.
11 buying on conirad, Fce Simple ownefs name
Remrdels otfice whera coniraU is recarCed
County
tl anY portion <
of the property
ramsnip
Legal descrip'on
sWUUre w the land not exceeding one (1) aae Ihat
ice irkome.
�/ /�/7�//l�/�
� disUicl (city,
Is fhe pn
7
wrtounds Iha
County Toxnship Counry
I hereby certify the above statemenls are W e, corted and complete. � �atui
��ress (num6e� and sVeet, city; sYate, 21Pcoda) ^ „
Record number
Pa9e
D�aU�M ❑ M1�obile Homo Q.C. 61.7-�
used to produce income, desrn"he Ne use and portion
Twvnship
0
20_Pay20_
Lesser of 1r2 Homestead
Vaueuon a 535.000
S
I