Homestead_Hirsch (14) STATE FORM 53169(8315-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE ICbl.l-22-8.1
- IMPO.RTANT 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
'pauses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
standard deduction to verify that they are 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.
-PA'TI; PROPER l'INFORMATION. .
Taxpayer Name Property Address State Parcel Number Leal Description:
•
Eugene/Clara Mae Hirsch 4782 0.'SR 68 26-22-05-200-001.601-024 PT E 5 4 I 1 90.4965 AC
CYNTHIANA IN 47612 D-2 1gf� �1 �p fm11rn 88
Complete and return to: I®IIDDlmillg EEIBf IIME� IEffimlllrnllll
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 fly fW lIJ LLII W
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
EL/9ane, • asaph Wirs ck
Maimg Address(norther and street.dry,state and ZIP code) I Same as pr0pe ly address
4184 w s R 41 (yr► tIlianu FN. 976 12- . . •
Social Security Number(last 5 dgits) - ' Drivers License/State ID Norther(last 5 digits) sae Other(pease specify in Part 4 below)
- -
First Middle Last
- lara • floe -) 1' r�s
C ck
MaSUg Address(nunter and street thy,state and ZIP code) E�Sarre as property address
47 ?2% 14/ S2 (9Y Cy/743lgh., -r/1! ii 76,I) - •
:.
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 Signature Date
- ' PART 4:ADDI I IO\AL•IN FORMA'1•ION - -
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• //
V
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a-'�� i CLAIM FOR HOMESTEAD PROPERTY TAX
s��i; CREDITISTANDARD DEDUCTION
�,;;• State Fortn Sa73 (F2 / S92)
�au
INSTRUCTIONS: See reverse side lorliling instructions.
a I� NarHO � EAR
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MAY 31gg3
/� �f�/� HUUI I VR " p�'Z
1(We) Prnl� �- l QA,0.- -� V 0.�_ certify ihat on the lst day of March, 19��
��e) �occupied our principal place ot residence the following described real propeny for which a Homestead Pmperty Ta�c Credit is hereby claimed:
'� We) owned ❑ Are buying under coniract � �
�Have a beneficial interest in ihe entity thai is liable tor the propeny taxes on the property and thai owns ihe property or is buying under a contract.
� . � CONTRACTRECORDED - � ��
If buying on contract, Fee Simple owner's name � .-
Recorder's ottice where contract is recorded Record number Page
PROPEfiTY
(city, Ia1yn. town5hip)
Parcel nu Der Legai de�ripU
p�'�-col(�o� '� � �. 5-�l - 9�.496��
If any ponion ot ihe residemial stmcture or the land not exceeding one (1) acre that immediatey surmunds that strucmre is usetl ro produce income, describe Ne use and portion
of the properry utilized Io protluce income.
��f��IL�o"��/—�iy1G
� PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES `
County TownShip Couniy Township
��� ��
reby certify ihe above statements are irue, correct and complete. Signawre of ciaimam
' d�pss (number and street, ciry, sfare, ZIP code)
i Z
ASSESSOR USE ONLY . TRUE TAX ASSESSED HOMESTEAD NON-RES�DENTIAL
VALUE VALUE VALUE VALUE
Land noi exceeding 7(one) acre immediately
surrounding residential impmvements. ��) �
Otherland (2)
Total land (line 1 plus line � (3)
Dwelling (4) -
Resideniial improvements
Garage (5)
Other improvements (6)
Total improvements (line 4 through lina � (7)
Total value Qine 3 pbs line 7) ' (g)
I hereby certify the above is irue, correci, and Sgnamre ot nssessor Oa�e signed
complete.
ying action - SignaNre of Auditor Dare signed
STANDARD
79_Pay19_
Lesser of 7/2 Homestead
Valuation or 52.000
�
SgnaNreotAUdi:or / \�� � �'�/I �Vd1e�f13 -93
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