Homestead_Scheller (5) ' STATE FORM 555110 hJ IS.I0) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNT.Ar! FRESCRIBID BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC 61.1.12-61
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
Princeton,IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore.
'""C HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
F benefit and,to provide additional identifying information necessary to allow county government to'bener monitor homestead
fili officials.filings.This information will be kept confidential and can only be accessed by authorized county ocials.The Department of
_...1` Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
. . ' PART 1: PROPERTY INFOR_NLATION
APR 1 3 2011 Taxpayer Name Location Address
C,0 n - Scheller, Kent W/Amy J
1751 E S
01880N COUNTY AUD TOR HAUSStnDT IN w 47639
2795 °
Kent W Scheller �� 10111_ III 011 1 01111.1010110110110110 illPI_III 011010111101111011011101011 III
1751E 1025 S
HAUBSTADT IN 47639-8024 11111111119111 1111111111111111119"119111"1111111111111111 State Parcel Number Legal Description
26-19-32-400-001.013-024✓PT SE SE 32 3 10 3.75 AC
•
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
1 First Middle - _Last
Mailing Address(number and street,city,state,and ZIP code) 3ame as property address .
f15\ E. • \D S - ���� I t4 (4--i b J
Spouse First Middle Last
Amy Jo. ' %- --inel
Mailing Address(Number and stet city,—State.a d ZlP case)—`- LJ c as padpety address —"'
.
. 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
CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
� � Slate Farm 5473 (RS / 10-01)
�� Presaibed by the Deparhnent o( Local Govemment Finance
INSTRUCTIONS: See reverse side /or filing insfructions.
,.; -� �
� FORM._.i 1'EAR
� NC10�J
i7AV o ?_ 2003
� ��Q�(lN Cv<?UTTV 4Wllun �
1(We) � cer6fy thal on the 1sl day of March, 20_
I(Wra occupied as our prindpal place ai residence fh fo 'ng descnbed real property for which a Homestead Property T�c Credit is hereby daimed:
�
CJ I(We) owned ❑!ve buying under conUad
� Have a benefidal interest in Ne entiry that is liable for ihe property taxes on Ihe property and thal owns the property or is buying under a conVact.
I( buyuig om m�Lad. Fee Simple ownefs name
Recorders affi[e whera mntrad is remrded
7avnship
al descripGon
+ �s �F �a _
H any portion of Me residentlal sW cWre or Ihe land not exceeEing ona (7 ) acre ihet imrtu
or me p.openy ou�¢ea m proauce ixome.
3.�
cilt�-/ i-._7is -/aci-vu�
:�:�?��°�#-:�����'�-����-�' aP
County Tavnship
-o� �
I hereby certify the above statements are We, corred and complete.
AEdress (number end s4eef, ciry, state, ZlPCOde)
Retord number
townshiP)
Paga
( � � Real Droperty LJ MoWle Homo (l.C. bf.1-� .
wrrounds Ihat swcture is used to produce income, describe the use and portbn
County
..» ..� 4. 'bwM1q`�'�:�.� "f t .a:' .. - t : - '�">',��"t - - ' w+'�xh^,�' ,. . .
� �o-i��� � - '�u�c���.rg�t.�-'•�-.�ST/WUARD:DEOUCTION'ALLOVJ/WCE-�°.�;, xi�x.z .��'Pwasar�a^�i� .��'":. �1.� �:?
20_Pay20_
Lesser of 1!2 Homestead
$
V�uadon or $6,000
Signature o(Audha " Date signed
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