Homestead_Miller (6) STATE FORl,51569(RJB-I0) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.1-22-8.1
,IMPORTANT NOTICETO HOMESTEAD PROPERTY OWNERS - - - s
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
auses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
s andard 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.
PARTI: .PROPERTY INFORM A •I`
Taxpayer Name Property Address Stale Parcel Number Leeal Description:
Keith G Miller 4195 E OAK RIDGE EST 26-23-02-400-001.985-024 OAKRIDGE EST 4
HAUBSTADT IN 47639
Complete and return to: I011II0f'1®11110 III nlrn I�®®m�n7��0 II MOM
•
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 lllllf • W
PART 2: 'TAXPAYER INFORMATION'_
Owner I First Middle Last
i g,ITh Garret 0 ;(lee
Mailing Address(number and street,city,state and ZIP code) 1 Same as Properly address
A145 a 6a1( 1249 t15— a-iuths-k.t..{, rrl 9�IL,31
.First Middle Last
(Ebn.ifa I—Ou M f t.itr
Mating Address(number and street aN,state and ZIP code) Same as property address
-
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/Signature Date
PART 4:ADDITIONAL IiFOR NATION E. _
•
FILED
• NOV 7 2012
DI
GIBSON L UUN I Y AUDITOR
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDR/STANDARD DEDUCTION
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P�eaubed by Ihe Depertrrent d Loml Gouermiad FinalM.e
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FORM
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Have a bene5dal mterest'v� Me entiry that is liade for Ihe property t�ces m ihe pfopaty and tl�at w�r�sl thg p�Qpeny.wTY AU ITOR a��
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I hereby certify the above 's We, correa. and SiB�ve o1�o Date sipied �
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Vei(yirg aWm - Si�aNa of AudAar Date s�red
20 _ Pay 20 _
Lesser oF 12 Hortestead
Valuation m 535�000 S