Homestead_Haley ME FORM SSN•nC r wl Tt ASIILR FORM MIA
.A/TMtw'ED BY TIE BOV D OrMent:NIS.9n PUSCRI ED BY nit DEIMNMEY1 OF Leta GOVER'MTAT ReaNCE MFI.I-Lit
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
• _ more beneficial,there is more incentive than ner for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
®
HEA 1374-2009 requires taxpayers who receive the homestead standard deduction to verify that they are elicible to receive the
benefit and to provide additional identifyine mformauon necessary to allow county government to Netter monitor homestead
finny:.This information will be kepi confidential and can only be accessed by authorized county officials The Ikpanment of
Local Government Finance will use this information to cream tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Haley, Shirley Trust
Po Box 410 cire
Haubstadt IN 47639
2078
Shirley Haley Trust
Po Box 410 State Parcel Number Legal Description
Haubstadt IN 47639-0410
26-19-31-303-000.149-009 013-00149-00 ORIGINAL PLAN 232/231
Spouse First C' l4iddie Last
le let
/ lei
Mailing Address(Number and street city,state,and ZIP code) l/ l ine-as'propeny address
�l7U(fi yr e_ /00/22 ? qi 0
Each undersigned certifies,under penalty of perjury.that the above and foregoing infonnation is true and correct and that he or she is eliuible to
..
FORM HC 10 1979 To Be Filed in Duplicate
Prescribed By State Board of Tax Commissioners
0/3' 0 0iy9 -o0