Homestead_Johnson[InrE wxsl E)w ip_ i.,Ml iBf v(LaLa waV %tn
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Gibson County Auditor F PROPERTY OWNERS
101 N Main
PRINCETON IN 47670 Individuals and tmrried couples are limited to one homestead standard deduction. As the receipt of this deduction bec uncs
more beneficial, there is more incemne dun eter for homestead fraud. Homestead fraud causes higher tat bills for all: therefore.
HEA 1344 -2009 requires ta[pascrs who revise the homestead standaW deduction to verify that they are eligible to receise the
beneEt and to provide additional identifying information remvn' to allow count' gmemment to better roomier Monte —.cad
filing.. this information will be Aryl cofdertnal and can oniv be accessed by nuthoriml county officials. The Delunime f of
Lneal Government Fit'mcc will use this infurmaton to cream rWs that will help count' officials eliminate homestead fraud.
PROPERTY PART 1: /' 1
Taxpayer Name Property Address
Johnson, Agnes I
427 S \lulhern' Sl'
Oakland City IN 47660
2001
Alvin R Johnson
427 S Mulberry St State Parcel Number Legal Description
OAKLAND CITY IN 47660 -1711
i I I I I I III I I I I I III I I I I 26- 14 -18- 304- 000.584 -007 016- 00584 -00 TR ADD 5 PT /6 PT BLK 5
t o tot nt n tent tat nr nt ta t tat ta r `y/
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 INFORAIIIATION
Owner I First Middle
RL/ /d �.
Last
OIIAIJd,J
g Address (number and street. city state, and ZIP code) Same as property address
Social Security Number (last 5 digits)
Driver's License/State ID Number (last 5 digits)
Other (please specif in Ivan 4 blow)
-
Spouse N First
Middle Last
Mailine Address (Number and''strem city', sate. and ZIP code) Ej Same as property address
/ //,� A
Social Security' Number (last 5 digiu) Drivers License/State ID Number past 5 digits) Other (plcLse specify in Pan 4 below)
I
sus
1
Each undersigned certifies, under penalty of perjury, that the above and foregoing information is true and correct and that he or she is eliuible to
receive the homestead standard deduction on this property. Each undersigned also understands that. by claiming additional homestead deductions
unlawfully, he or she mayibe liable for back taxes and substantial financial penalties.
Owner 1 Signature
yrtt %C ,'d Z,r'nn
Date
'f �� ion
/ 1
Spouse Signature r Date
Telephone ( l
PART 4: ADDITIONAL
•4 •: di r3 -
1' 1
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