Homestead_Greenwell STATE FORM 53569(8311-10) TREASURER FORM TS-IA
APPROVE!)BY STATE-BOARD OF ACCOUNTS.'_o09 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE 1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS a
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
•causes 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. /
- PARTI: PROPER V INFORMA ION -
Tasrsarer Name Property Addres4 State Parcel Number J.eeal Description:
David E/Frances M 3312 S SR 57 26-13-26-400-001.142-006 PT SE SE 26 2 9 1.748 AC
Greenwell OAKLAND CITY IN 47660 C_i
Complete and return to: IBIRIU]II0000D]OQiftlltll➢11HI llIIIIJI!]IJI(ll
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
t • : u : •
Omer 1 First Middle Last
X)Atire) gu q tN GRE-A✓t,uEct
Matting Address(number and street,city,state and ZIP code) l. s
ill as properly address
33/2 S SR57 O.4kbp,v1) Cary _L-At g7G(o
/ /
apouse Fust Middle Last
Dee e.p S Co
Mailing Address(number and street,city,state and ZIP code)
I Same as properly address
Social Security Number(last 5 digits) Drivers License/State ID Number(last 5 digits) Slaw Other(please specify in Part 4 below)
: ._i PA•T3:•CERT FIC• 0 e:_.K:_ e• ;ia, rte:: y,..
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 1 Signature Date
NA+ ZIN S * op RES S
P0. Fox / 53 -
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