Homestead_Frohbieter STATE FOAM.5351.•tit'/sPt TAFASOknn FORM TS-IA
APPROVED BY STATE MNRDOI A!RAINTS.:my Ptrr,1Bm BY 111E DEPARTMENT OF LOCAL GOVERNMENT FINANCE ICMYDr.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
more beneficial,there is more incentive than e'er for homestead fraud Homestead fraud causes higher tax bills for all:therefore.
ill
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to serifv that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filinto.this information will be kepi confidential and can only he 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 C\FORMATION
Taxpayer Name Property Address
Frohbieter, Jerry R Q\`
•
R2
Ilaubstadt IN 47639
2055
Jerry R Frohbieter
12014 S 200E State Parcel Number Legal Description
Haubstadt IN 47639-8004
ItiuIllntitllnnlltltluinit ilntllnnlIuln tlltlIIil il lil 26-23-09-300-000.347-024 004-00347-00 PT SE SW 94108.58 AC
PART 2:TAXPAYER INFORMATION
Owner I First /� Middle rp Last
�ERG�v /? / /l 0�IQ/.Ci��4
•tag-Address(number and slum city:state,and ZIP code)__ --_ _ — _. -_ —— - "Satre as property address - _ _ _ -_ _
/1 0/1 S. zoo 4
Spouse First Middle Last
N0A/6
Mailing Address(Number and street,city,state,and ZIP code) ❑Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sure
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is tree 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 Si ature Date
�} CLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
� State Fwm Sa73 (R6 / 403)
Prescri6ed by the Department of Local Govemment Finance
INSTRUCTIONS: See revcrsc sidc loililing inslruc(ions.
FORM YEAR
HC10
� � � � �
I(We) (/ � certifv�that on the 1st day of March, 20
I(We) occupied as our principal place esidence the f "ng described real property for which a Homeste, p��d� GP�r.o�pe,�r[y.,�T Cretlit is here da' ed:
❑ I e owned ❑ Ne b /o -7 "J�
(W ) uying under contrac GIBSON COU 7 Y' .4UDITOR
' Have a benefidal interest in the entity that is liable for the property taxes on Ihe property and that owns the property or is buying under a wntraU.
I( buying on conVact, Fee Simpie ownefs name
Remrders offica where wnVad is recardeA
t���ar���-�''i3it���'`'t�"�X+.�.-.�`°�.-''_"" .°-:�
Counry � Toxnship
IdN.
Pa�O be� V O�� / I egal desai�� �� �� /� 5�l
z-�i_J I
N eny poM1ion af Ne residenllal sWCture w Me land no� exceeding one (1) arre ihat immediately surrounds
ot the property uliGzed tn praduce income.
County
Township
�
I hereby certify the above statements are We, corred and complete.
(number and s4eel, raty, sfafe, ZIP code)
%l , /j. � /3 m X �� </ . /-�Fi- v
Rewrd number � Page
Real property ❑ Mobile Homo (I.C. 67.7-7)
ve is use0 to produce income. describe the uu and portion
-/�v. � •ri- vor r
ITFIN;OTHER`COUNTIES��.�`'.�� �
�tY Twvn:
�
of daimant
I � ��.��
�' _ S�'o . h/ 7� �
�"`%� "��°'��c'�'.r��;�'i�.r"`''�..��-,.��- - , i r �w. .�. 1-:.,.� . . .. ,�,,,
��- -�''ASSESSOR��USEONLY-.. � �UETAX �ASSESSEDVALUE�+HOMESTEAO�� iNON=RES�DENTIAL }
�,c;��, . .,_�.7�,p�y��,�r�� . ;,.� VALUE�.�,.ATw100%OF3,.��.fi,.��VALUE��� VALUE'��c�
�`. �.>__. � �'�....s..l.�.�_.
� �� � �
Land not exceeding 1(one) acre immediatety � ��,� %; :W„�".+-,�,'*�*°„��};t,��r`i y;�',.��
surrounding residenUal improvemenLs. � � `>�; � �' "'�� ,`��,�.�,_�,�4„{�-�.
�'3:_,a ' _-,c s.
Otherland (p� a�''s'y ��A.-� t
� _ FE':J��
Totalland (line 1 plus line 2) (3�
Dwelling (4) � ����%.�i��� '�
Residentiel improvementa or Mnually �
�.� 91�..�r:�'°� "
0.ssessed Mobde / Manufachtred Home C,y�yye (5) ��+'�'�..� T,- �i%��',�
?�.�.�+aa?�a��'�.'� ,Y-'��
4ys�=2�'y�, �' 3i
Otherimprovements (6) � ��,��i��
'"v �e�_ .
Tdal improvements (line 4 through line 6) (7)
Tttal value (line 3 plis line n (g)
I hereby certify the above is We, corred, and Signawre o(Assessor oate signee
complele.
Veliryring action - SignaNre o(lwditor Date signetl
���','��'����V`'��*�,`�,'?;ri,",.-�'��5�_ 5�,._,��STANDARU:DEDUCTION'qLLOWANCE���;'�,�y�3, u �;c��. '� �:•
... �':i�ver.=T�-�' �'`�3....�a`'l`�4'F
20 _ Pay 20 _
Lesser of 1/2 Homestead
va non a .000 $
Signature of Date sign
il- a3- o