Homestead_Gries (4) STATE FORM 53569(R3113t0) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 - PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE 1061.1-222-S.I
IMPORTANT NOTICE'.TO HOMESTEAD PROPERTY:OWNERS -
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. Homestead fraud
uses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
s dard deduction to verify that they are eligible to receive the benefit and to provide additional identifying
it
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. •
' r PAR I, :.PROPE' Y INFO'MA ION ,- -. ,
Timmer Name Property Address State Parcel Number Leeal Description:
Richard/Karen Ann Gries 1 1990 S 50 W 26-23-07-300-000.379-024 PTE SW 7 4 10 2.00 AC
HAUBSTADT IN 47639
Complete and return to: IYU1IDOJ1111IIM11111110mIDWm®E®11'I MO E
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 LLI
PART 2: TAXPAYER I NFORMATION . . .
Owner 1 First Middle Last
Kitk&rcL -�) L atvrCiAce 6' r /CS
Mating Address(number and street,city,slate and ZIP code)
ijSeme as property address
/ i qqo ) Co 747 Nita b5fa�f- -7:A) 4L-763 q
. - First • .Middle Last
•P-rev\ 4-v, h . . 6 ries
Mailing Address(number and city,state ZIP el I tlress/ / q q' 5 O §/ t,t h s tQd t, .r / 763
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 gnature Date
. - PART 4:ADDITIONAL INFORMATION -
. i 5 .
. KCAL-Li-242
c. .m `
GIBSON COUNTY AUDITOR
•
FORM HC 10 1979
Preuri�ed By S�ate Board of ia. Commissioneu
CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOR YEAR 19 7 g
io Be Fi1W in OuD���ate
SEt t3AGK FUH hILING INSIHUGIIUNS
��(WP� rl����---++ ��l�l�G� certify that on the 1st day of
�vlarch, 19�, I, (VJe) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned �Q �_ �D 3/� o0
O are buying under contract
❑ have a beneficial interest in the taxpayer g%� _ Gj% _ Q� ;�/ _ 06D• ,2 �J�—Qa �
Property Description in �—���--.�_- County �/ Township
Taxing District (E+iy; Tswn, Township): ���-d-K�
Parcel Number
If buying on contract Owners name �'� ��mo1e owneq
or legal description shown on tax statement:
Pf. F'� Sw� 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 immediate�y surrounds that
structure is used to produce income, describe the use and portion of the property utilized to produce income
Any other counties in which individual owns or is buying real property:
� hereby certify the above statement is true, correct and complete.
��/`�G��a-��Q�� �?� l��/%aX.33 8� ,
'Signamee
SI�Qp� Atl4R55
County Township
u6Sf�1. � 5�76.� 5
lwry. ma�e anO uo lAde
' Individual either owns or is buying under a contract that provides he is to pay ihe property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
True Cash Assessed Homestead
TValue Valuation .Valuation
Land not exceeding t(one) acre immeckdt�
surrounding residential improvements +�j � (�l .5-0 0 / 70 / 70
M �or ��//���/�i�,.
Other Land
Total Land
Residential Improvements
Other Improvements
r-
�� Ay 3 `� �979
//
AUD
Total .
Improvements - Line (6) plus (7) equals (8)
by certity the above is true. correct. and complete.
(2) �
(3) j� o 0
(4) � 70? O
(5)
(6) _�_�' � a_O
(�)
�a) as7ao
- ACTION BY AUDITOR -
.
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Date: ���l�