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STATE FORM 53 STATE OAR TFAWRFA FORM MIA
APPROVED BY STATE BOARDOF ACCOUNTS.AW PREMIUM]BY THE DEPART-MO.-FOE LOCAL GOVFA MENflNM .IC6-rI-S]AI
a
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 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
• _F II, benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
y-� filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
ppL00 Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORNIATIO\
MAY 1 7 2011 Taxpayer Name Location Address
C C Bechtel, Robert N Jr
2492 E DEAD LEVEL RD
GIBSON COUNTY AUDITOR HAZLETON IN 47640
129
Robert N Bechtel Jr Jr. 11111011 rim II1111 mu 11111011101111 II II II_Ill 111[I.1111.1110111 III[II II II
2492 E Dead Level Rd
Hazleton IN 47640-9273
IIIIII'IIII'III111111111r11111111111"'11'1111"'1111"111'1'1'1' State Parcel Number Legal Description
26-02-47-168-000.453-0117/PT LOC 168 1-10 1.71 AC
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:TAPAIER 1\FOR\ A0\ ___ - __ __
Ch. er l First Middle Last
Mailing Address(number and street.city.state,and ZIP code) 0 Same as property address
t ■LIGZ E )c \-e-sL\ G--\ tar. 1\ y-i b o
Spouse Firstl Middle Last
Mailing Address(Number and street,city,state,and ZIP code) 0 Same as property address
r
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
I I I I I I I Sine
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
Ape Signature Da Telephone
•
)
PART 4: ADDITIONAL INFORMATION