Homestead_Greubel (9) stall FORM!A.•M.III/!+MI TPfAAI[FA FORM TS-IA
AflB 'EO BY"Pat WWIOOf Mr03JS 1,1.N PREYglntl)BY THE DEPAaneer rrux-at nna2R4Mr117 FRANCE Ks-1.1-224a
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 ever for homestead fraud.Ilonlestead fraud causes higher tax bills for all:therefore.
• HEA 134--7009 requires taxpayer who receive the homestead standard deduction to verily that they are eligible to receive the
benefit and to provide additional identifying infomtation necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only he accessed by authorized county officials.The Depanntent 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
Greubel, Larry P/Janice A
R2 Box 167
llaubstadt IN 47639
10902
Larry P/Janice A Greubel
11811 S 200E State Parcel Number Legal Description
Haubstadt IN 47639-8006
IrIrrlltttlrllrttuIItI.irrlrtltlltttllttutll Iltutll111111 26-23-09-300-000.396-024 004-00396-00 PT SE SW 9410 1 A
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PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
L fi-R 24 l°- CR C U 4 EL
Ig Address(number and street.city,state,and ZIP code) - - - -- - Same as property oddre s —//S An;n E NA(/BsrMarr cj7639
Spouse First Middle Last
-,L/r eE A - fir, eeta GEC,
Mailing Address(Number and street city,state.and ZIP code) Same as property address
,g //S 010 C / Atia.5 AD7 Tat/ 14 7635
/
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 or she may be liable for back taxes and substantial financial penalties.
Owner 1 Sia•"tore Date
•
FOFM HC 10 1979
P�ewiGed By State Boartl ot iaa Cammissloners
7o Be FileG in DuO�icate
CLAIM FOR HOMESTEAU PROPERTY TAX CREDIT FOR YEAR 192�
SEE BACK FOR FILING INSTRUCTIONS
�(We) '1 certify that on the 1st day of
� arch, 19��, I, (We) occupied our princi I place of residence the following described real property for
which a Homestead Property Tax Credit is he eby being claimed: �
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in �,�� County
Taxing District (.Ciiy, T�ewr3; Township): ���-+_--�-,�
Parcel Number
If buying on contract: Owners name �'� 5inip1e Owne'�
�D�_ 4o�9�-Da
Township
or legal description shown on tax statement:
/�f. 5'E 'v Sw y 9- v-io /�,�
Contract recorded in Recorders Office - Record
If any portion of the residential structure or the land, not exceeding one (1) acre that•immediately surrounds that
structure is used to produce income; desciibe the use and portion of the property utilized to produce income
-�3-D 5=3oo-aoa•
Any other counties in which individual owns or is buying real property:
�hereby certify the above statement is true, correct and complete.
County
Township
��
'G3 g
Assessed Homestead
Valuation Valuation
/ 9 0 �%ii�i,%��
' Individual either owns or is buying under a contract that provides he is to pay the properiy taxes .
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY
Land not exceeding 1(one) acr�im�at�
surrounding residen{�t�3 i�rove ents
Other Land
Total Land � loi(�
J Li i� � f} —�' . J
Residential Improvements Dw �Iling
� ,C��A�,�Gafage
U /
AUDITOR Total
Other Improvements
T�Improvements - Line (6) plus (7) equals (8)
{.. oy certify the above is true. correct. and complete.
OI FSSC550�
�
�
True Cash
Value
(t) Soo
(2)
(3) 5.' o 0
(4) / j' G: / c
(5)
(6) / 3lc/O
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(g) /.� � Jo O
- ACTION BY AUDITOR -
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Date: _ a(O � 7