Homestead_Russell (5) STATE inch'f5+nR'/w^r MAwiLER EO104 11A
APPROVED BY STATE BOARD OEMTai:i.S.`nu 1LIATUBEn BY THE DEPART4E4T OF LOCAL OOVERVMTT FO:AYCE M�Ti.t4.t
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
6 more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1547-3009 requires taxpayers who receive the homestead standard deduction to verity that they are eligible to recene the
benefit and to provide additional identifying information necessarc to allow county government to better monitor homestead
filings.This information will be kept confidential and can only he accessed by authorized county officials The Department of
Local Government Finance will use this information to create tools that will help county official.eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Jacobs, Stacy S
915 S Stout
Princeton IN 47670
1519
Stacy S Jacobs
915 S Stout State Parcel Number Legal Description
PRINCETON IN 47670-2741
1111111111 1111111111111 26-12-18-202-001.032-028 019-01032-00 SS ADD 364 PT/365
I
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:TAXPAYER INFORMATION
Owner I first Middle Last
ShcuUn tss1/4tl /
4g Address(number and s city,state,and ZIP code) [] Same as property address
9/5 QS Slat I- N— 1Rainceior1
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 •
,
,