Homestead_Julian STATE FORM 53569(R3l11-10) • TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC61.1"-8.1
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
(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.
PAR 1: PROPERTY MIA -ION
Tumyer Name Property Address State Parcel Number Legal Description:
John D Julian 2497 W 102$S 26-I8-34-400-001253-024 PT NE SE 34 3 11 5.90 AC
FT BRANCH IN 47678
•
Complete and return to: I®IIDDHDDD llOnlaI0 Sahli D0 Nl El 111l®
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
• PART 2 TAXPAYER INFORMATION
Ovmv 1 First Middle Last
Mailing Address(number and street city.state and ZIP code) I vl game as properly address
Last
Magog Address(number and street.cry,state and ZIP Code) Same as property address
Soda)Seamy Nunter(last 5 digits) Drivers License/State ID Nunter(last 5 digits) State Other(please specify in Part 4 below)
PART 3: CERTIFICATION. _
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is eligible to receive the
homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions unlawfully,he or
she may•- liable for back taxes and substantial financial penalties.
Owner Date
PART 4: ADDITIONAL INFORMATION .
.
- • Fit•
DD
NOV 7 2012
c.a
GIBBON COUNTY AUDITOR
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Sleta Form 5/73 (R6 / 4-03)
PreacAbeO by tlro D�rtnenl d Local Gownment Finance
INSTRUC710NS: See re`erae ffi7a b fPnp iy6uctiona
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FORM
HC70
YEAR
I(We) �/ � c�rtify that on the 1st �xe�March, 20
I(We) occupi as our principal pla i residence Ihe following described real property for vfiich a Homestead Pro��T� �e '�is ereby daimed:
�.Y(We) owned ❑ !ve buying under contract /�{��,
` Have a benefiaal interesl in ihe entity that is liabte (or ihe property laxes on the property and that mms the prope- r�fi�Sim.bupidiiu$'der a contraU.
If buying on conllad. Fee Simde owners name
Rem(ders ofice where wntrad is recordetl
County
N any poAion c
W the OroP�Y
County
7avnship
53�06 `�
al sWCWre w fhe land not
duceirxome.
Twvnship
Record num6er � Page
Tating tli5tritt (d fown. f iP)
3�^� � r Is ihe pm in question:
� eal property ❑ Mobile Homo (I.C. b1.7-7)
one (1) aae �hat unmeAiatey wnounds that sWC[ure is useA W produce inmme, desaibe Ne uu and portion
I hereby certify the above statemenis are W e, cotrect and complete.
Address (number aM sVeet, cdy; afate, ZlPcode)
Land not exceeding 1(one) acre immediatety
surrounding residential improvemenCS.
Other land
Total land (line 1 plus line 2)
Dwelling
�Residemial Improvementa or MnuaOy
A�ed AbhUe � Mar�uf�red Hane Garage
Other improvements
Tdal improvements (line 4 through line 6)
Tdal value (line 3 plts line �
I hereby certify fhe above is We, corred, and
complete.
Veitying aclion - Signature of ALditor
20 _ Pay 20 _
�esser of tr2 Homestead
vewauon or 535.000
synature or PLaitor
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(2)
(3)
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(6)
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ofA55essor
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Tavnship
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Date signed
Date signed
Date siq�� Q ^ Q �
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