HomeMy WebLinkAboutHomestead_Holzappel (2) STATE FORM 53569(RHB-Ig) TREASURER FORM TS-IA
APPROVED PT STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINA.NCEIC6-I.1 22-8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS ':. - •
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
r'-. uction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
auses 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.
PAR 1: PROPERTY INFORTMA ION - - .
Taxpayer Name Property'Address State Parcel Number Leal Description:
Thomas D Holzapple 10375 S I SO E 26-19-32-400-000.604-024 PT SW SE 32 3 10 2.526 AC
HAUBSTADT IN 47639 1
Complete and return to: I®hID[11I80]IIDflfUImm it m Hi B11E10111n1®
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 1 W
T - )/ .PART 2:TAXPAYER INFORMATION. - >;;
Owner / c ' c m e/ First ��/h./`, r Middle • /o/2_4ll Last•
Mailing Address(number and street,city,state and ZIP code) I Same as property address _7//
/0 32.515- /so,le /412)57 /A7 r7'3?
-
Spouse First Middle - - Last
D (4- /C7 Et)i2.A//LS /4 12)91P�
Mailing Address(nunOer and street,city,state and ZIP code) Same as property address
/03 75-s /.so , /%u45 TAC9r //V Y76 3 ?
i 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 I Signature Date
N ,PART 4:ADDITIONAL INFORMATION , -
ry� s CLAIM FOR HOMESTEAD PROPERTY TAX
' ' CREDIT/STANDARD DEDUCTION
`� � State Fortn 5473 (R4 / 8-00)
.. �.�.
INSTRUCTIONS: See raverse side (orfiiirg insWCtbns.
FORM � Y R
HC10 O �%d-
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I(We) w�J � � ceitify Nat on the.lSt ay of rchl20_
I(VJe) occupied as our principal place of residence the foliow'u�g desaibed eal ro e for which a Home� e ro "' �daimed:
�(We) owned ❑ Are buying under contract GIBSON COUNTY AUDITOR
ave a benefidal interest in the entiry that is liable tor the property taxes on lhe property and that owns the property or is buying under a contrad
II Mryiig on conVact Fee Simple ownefs name
Tams�ip
Taring
Record number � � Page
��"=�o�F-c� "1�f���� LJ �� �3a -3 - � b a- S a��
It arry portion ot Ne resitlential sWdure or lhe land imt ezceetling one (t) acre that immediately surrounAS Nat sLUaure is used to produce inoome, Aescribe the use and portion
ot Ne property utiGzed W ryoduce income. �- ' �
County
� / / - 'LJOi - / UL! -
`��`��'� PROPERT
.� ._�„x.�rac�- . - -
.� Tavnshio .
I hereby certify the above slatements are true, corred and complete.
and
Twrnship