Homestead_Elpers (26) tIME 1ORM!!M*iRr Nrt TILE'S:MR FORM TS-IA
.MPPmEo BY STAIL wwnnf AMEN'S.bra PIFYWFW BY PIE DEPARTMENT OF LOCAL GOVERVM @T FACE MN.1"-n
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 becames
more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher In bills for all:therefote.
• HEA 1344-2009 requires taxpayer who receive the homestead standard deduction to verify that they arc 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.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Elpers, Patricia A
12225 S 200 if
llaubstadt IN 47639
11021
Patricia A Elpers
12225 S 200E State Parcel Number Legal Description
HAUBSTADTIN 47639-7973
26-23-16-100-002.245-024 COUNTRY AYRE EST#2 LOT 5 D-9
111111111111111111111111111111111111111111111111111111111111111
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PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
ATI2lcin � �LPE1ZS —
tg Address(number and street,city,state,and ZIP code) Some as property address
/aaa5SB aboE //AUESTK4DT 2-p 471,39
Spouse First Middle Last
Mailing Address(Number and street city,slate,and ZIP code) Same as property addtESs
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 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 1 Signature Date
•
•
Cl111M FOR HORAESTEAD PROPERTY TAX FoR1A �
CREDIT1STAiVDARD DEDUCl70N HCto
smm r� saa �� i sau�
Pieffibad by tlte DepaMieM aF Lotal Gwertmerd Finanae :� a�r lr1 lr\
INSTRUCTIONS: See ieverse side for Aing in�Sons.
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1(We) ocwpied as ow prmdpal place M residence tlie 'rg desubed real propeAy tor whidi a Hanestead Property T�c t is hereby daimed:
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Have a benefidal inffirest in the entiry thet is liade iw Me propeAy hnces m ttie propaty aiW tl�at or�1B�Q1�@}i�iTsYb�ii�blPoBr a contract
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rty LJ Mabik Home (LC. 61.1-� �
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