Homestead_MorganID:
D. PREPARER , / `'
Preparer of the Sales Disclosure Form
�
N. Hart St.. PO Box 13
ess (Number and Street)
Princeton, IN 47670
City, State, and ZIP Code
E. SELLE
Jesse B. Medeirns
Seller I - Name as appears on conveyance document
Address (Number and Street)
San Leandro. CA 94577
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and com a as red law, and is prepared in accordance with IC 6- 1.1- 5y5n'Real Property Sales isclosure Act ".
Signature of eller Signature of Seller
Jesse B Medeiros Oy /a9 /2olb Madonna M Medeiros 0 y /09IAVto
-'F.BUYER(SVGRAN'r&F(Sl - APPLICATION FOR PROPERTY TAX11£DDCTIONS- IDENTIFi�ALL ITEMS THAT APPLY
BuyerI -Name asapvr�On convevance document
Address (Number and Street)
_
conveyance document
OF THOSE THAT APPLY.
YES NO CONDITION
Q ❑ 3. Homestead
-t::��gy
Heating /Cooling System
F]
0
S. Wind Power Device
n
Q
6. Hydroelectric Power Device
L]
Q
7. Geothermal Energy Heating /Cooling Device
EJ
0
8. Is this property a residential rental property?
n
9. Would you like to receive tax statements for this
property via a -mail? (Provide contact information
below. Please see instructions for more information.
Not available in all counties.)
o?G 3 -/9 ;,-
Gene and Krisrl Morgan
name E -matt
STATE FORM f55>R IRE/LIB) TREASURER FORM IS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.A% PRESCRIBED BY TIE OEPARTAET OF LOCAL GOVERNMENT FINANCE IC 61.1-22-LI
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS '
141 N. Main Street Individuals and married couples are limited to one homestead standard deduct ion. As the receipt of this deduction becomes
•,.�'Pdej¢n, I I�37GD more beneficial,there is more incentive than ever tot homestead fraud Homestead fraud causes higher tax hills for all;therefore,
gq� 11 1L,�H_/ HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
albenefit 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
MAY10 2011 Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
C ..
J.njr 1
v Taxpayer Name Location Address
GIBSON COUNTY AUDITOR Medeiros, Jesse B/Madonna M
501 W SCHOOL
' FRANCISCO IN 47649
_J11110101 4 764 9
4564 111 0111001 11lfi 00111011000111liILI0
11-11II IGeneSMorgan
501 W School St ,
FRANCISCO IN 47649-9290
'I'lll"Illli'I'il'II'lillllllll'lililllil"lll'i'il'll'iill'I'll State Parcel Number Legal Description
26-13-19-202-000.157-005/ OLD PLAN 73/74
G
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.
__.___.._,_._____-_ ._.__-. PART_2: TANPAYER INFORAL4TION _____- ____._____ - __ — _
Ou.._ ( First Middle _ - _. _.____fit_ __
Mailing Address(number and street,city.state,and ZIP code) ca Same as property ad
Spouse First - Middle Last
Mailing Address(Number and street,city,state,and ZIP code) - Same as property address ki
•
Each undersigned certifies,under penalty of perjury,that the aboviand 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
•