Homestead_Sullivan (2) •T.\It FORM W4 R3',-lul Ill`ASI:RIR IOLM ISIA
• .VPYmtO 01rIVE 3O1Rn OF.11 l a I 1Zl(1.m iRESrImED nl'TM.FILM IMLT OE LOLLLCO\TAMLT ILNANCE IC 1-11-224A
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 m\bills for all:therefore,
0 1 I T II EA 1344-2004 requir taxpayers who receive the homestead standar!deduction to\eriry that they are eligible to recei\e the
erequiem.bandit and to pen isle additional identifying mnmmaoon necessary to allow county government to better monitor homcacad
filing.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 took that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION •
APR 2 4 2012 Taxpayer Name Location Address
C p\_ny--- Sullivan, Tony/Sheryl
%v�`w
159 N1750E
GIBSON COUNTY AUDITOR OAKLAND CITY IN 47660
4241
III IDII DI DI IDDIII[10111 IDDi ]IDIDIImDDm1 II AnthonyLSDlliyan
159 N 1150 E
OAKLAND CITY IN 47660-8608
"IIIIII'IIII"ICI'III'IiIllilIIIIIIIIIII'1I11l!JiilllliIiliilii1 State Parcel Number Legal Description
26-13-12-204-000.943-006 PT SE NE 12-2-9 2.20 AC C-1
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.
t ` 1 7 • 4 `
a I First Middle - _ ---- -fast------71/1-/-110n Li L nn So //1vQI
Mailing Address(number a street.city,stare.and ZIP code) ® Same as property address
/57 Ai. 1 1 s E. crk Ida not O'/ , 1 AI y7 60
Spouse First Middle Last
ghe l
4113 "7 Ill sully ✓c� n
Mailing Address(NU r d sttreet city,state,and ZIP code) Same as property address
- - - /-59- N. 1 / 50 6 - Ocic/a-nd---& --- - /nJ gl760l00 -
.
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 Si nature Date
- '
CLAIM FOR HONE7STEAD PROPERTY TAX CR DIT FOR YEAR 19_
arch, 19 11
(We) crm' as oyz`
Woperty for which a tai Pro
Z, Ole) B -m -ned
Fl are bryinq under contract
have a beneficial interest
Property Description. in
Tas:inq District (City, T(7,-.Ti, Township):
Parcel ilumrnrr
FOR FILING INSTRUCTIONS 003_ tjgUtg3_00
!, � certify that on the 1st clay o
-incipal place of residence the following described real
Tax Credit is hereby being clained:
the taxpayer
County
Ta-,=Iii
or legal description
property: County ']aemshio
shown on tax
staternnt:
PZJe �3"' 72
f �/
/oz -a 9
,2. z o 4C
If buvi—no on contract: Cmners nacre (fee simile ov-ner
Contract recorded in Recorder's Office - Record Ib. Page
If any portion of the residential structure or the land, not exc-- ling one (1) acre that
irnpediately surrounds that structure is used to produce inane, describe the use and portion of
the property utilized to produce income
Pny other counties in which individual owns or is boring real
property: County ']aemshio
hereby cer—i'lify the above
�i�it
statarent is true, correct and complete.
aL �=
SZ
y7G ZS
�4
Street Pdaress
City, StaVrrd
ZIP Coar
*Si .afore
*Individual either
cans or is buying uner a contract t1a3t
provides he is to pay
the
nrope_rty taxes on
the residence, or has a beneficial
interest in the to yer.
- FOR ASSESSORS USE ONLY -
True Cash Assessed Itrrvstea
Value Valuation Valuatio
Lard not exceeding 1 (one) acre irrcneciiately (1) SO o 1-70
/ -70
surrounding residential irnroverents
o ,, —o Y/////" // /�% ;
other Land (2) S 2 Z
To
0111, V/00q;
P s}�en r Lwelling (4) 11 Vol
MAR 2 7 1986
Garage (5)
Total (6) 0
the-�'Iftpr -Em
To lmror,•arents - Line (6) plus (7) eauais (8)
hereby certify the above is true, correct,
and oamlete.
Date
Si-mature of Pssessor
- ACTION By AUDITOR -
.� Date:
i ::,crov�i