Homestead_Johanningsmeier STATE FORM 53$69(R311-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1-224.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS a -
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
Sauses-higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
Bard 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 I: PROPERTY 1'FORMATION
Tupaver Name• Property Address State Parcel Number Legal Description:
William R Johanningsmeier 9962 S MISTY LAYNE 26-18-36-200-002.317-024 MISTY LAYNE LOT 2 (.58AC)
I-IAUBSTADT fN 47639 IfB 7 1I It
Complete and return to: IfhIMmuaulIMEI m mmeionommimuimua
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2:TAXPAYER INFORMATION . -
Owner t / First Middle j /- 1a51
/.[/�•/(a r /- //J A ck �,! . Jc7/7Q/2i1!/7 R Sine, P✓'
Mating Address nunter and street city state and ZIP cede) /
L)cJ Sarre as progeny address ✓
996 S; "
�_ � µtir ��
///A re-7A— / yh/? _Jd Jo<-2/i705 /'�'icI'er4
Maring Address(number and steel dry,state and ZIP code) l
IA J sane as progeny address ✓
5'9607 s / /15-/)(
PART 3: CERTIFICATION .. - •
Each undersigned certifies.under penalty of penury,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 1 Signature Date
1 PART 4:ADDITIONAL INFOItMMATION
. . I
■ y •
F , F. ix....:
NOV 1 3 110'1
1
GIBSON COUNTY AUD'TO3
CtAIM FOR HOMESTEAD PROPERTY TAX
CREDR/STANDARD DEDUCTION
srete F«m Sare �a� i s-os�
Prascnbed by ihe Departmant of Laal Gwertonent F'vwice
INSTRUCTIONS: See reverse side for (Iing instructions.
FORM
HC10
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I(We) ocwpied as our prindpal place of residence Mie folbwi`y desai real property for which anestead Pioperty Tmc i by daimed:
❑ i �we> �a ❑ Are buymg under cmtract JUN 2. 9 2007
�Have a benefidal interest in Uie entity ihat is liable for the property �ces m the {xoperty and that ams the property or is buying under a cantract
If buy'vg om m�traG, Fee Sirtiple owners reme
Recaiaer§ af5w rhue mmaa ia iacaam
Tonstdp
�b-��-��aco -o�3n- p.�y - - Y � � l�
H airy pation of the residmdial ctruchae a the Imd rw1 exceeding ore (1) aue
d U�e paperty W5md b protluca cimne.
I he2by certify ihe above statements are true, corred end cortplete.
(nuMeraMaLeeL oA:9ate. ZlPcode)
ii' �i i n n.� � il J /1 / / .J-�
Land not ex�ng 1(one) aae irtrnediatey
surrounding residential improvemenfs.
Otha IarM
Tdal tand (I'vie 1 pkis fare �
Residential'unprwementsorMnualy ����
Pssessed �M6de / Manuf�ued Flome
Garage
Otlier imprwarien�
TUaI 'vnprovemerrts (�ne 4 Nvo�� Gne 6)
Talal value (lirre 3 pl/s Gne �
I hereby certity ihe abwe is true. cartect. and
ounplete.
Vaiy"vg adlan-Sipretae dNdOOr
20_Pay20_
Lesser af 12 Homestead
Valuatim or f35,000
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airmunCs Urel s6urAae is uaed tn produoe'vimme, desaibe the uae end portion
Caunry
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Tavnship
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Date sgned
Date signed