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CLAIM FOR KPESTFAD PROPERTY TAX CREDIT FOR YEAR '
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Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead .,undanl deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than escr for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
• ILEA 1344-2009 requires taxpayers who receive the homestead standard deduction to serify tam they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
tilint>.This information will he kepi confidential and can only he accessed by authorised count'officials.The Department of
Local Government Finance will tee this information to create teals that will trip county officials eliminate homestead fraud.
PART 1:PROPERTY INFORMATION
Taxpayer Name Property Address
Collins, Dwight D/Connie R
R I Box 245 /(�
Ilazleton IN 47640/(I'
965
Dwight D/Connie R Collins
7230 N Thompson Rd State Parcel Number Lethal Description
Hazleton IN 47640-9353
I I I I III I I I I I I I I I I I I I I I I III 26-05-57-109-000.107-017 009-00107-00 PT MD 109-1-10 25.34 AC
I e( III F nl n Ile Inn ll r nr ul I nil a C-1
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
t V15
ig Addnss[niirnba and Street.city,state,and ZiP code) _ '-- - male rIS property oddr - ' - - ---
Spouse First Middle Last
mow , �,-� CO
Mailing Address(N t�Cm -r and street.Lily,state,and ZIP code) 'Frame as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
gtr s , See (o 55
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.
Own I lgnature ��.5��/�✓`/""°- Ust
PART 4:ADDITIONAL INFORMATION
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