Homestead_Willis (3) CLAUM FOR MU DD PROPERTY TAX CREDIT FOR YEAR la .
•1 SEE BACK FOR FILING INSTRUCTIONS •
=, ---vie) eCiAr4 ( �o '4. 19QJ1t WIL44 t8 cerEify that on the 1st day c
'-emuch, 19162 I, (Pie) occupied as our principal place of residence the following described real
rty for which a licaesteth Property Tax Credit is hereby being claimed:.
I, (h') E(awnei —
are buying tinder wiilLd^t
E have a beneficial interest in the taxoayer -
Property Dscription. in
�Y9<1eN\ County `D Ux-Qu
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Taxing District (City, Taal, To wn_ship) :
Parcel Dumber I I I I I or legal description shown on tax statement:
If buying on contract: Owners lane (fee simple owner)
/, z 2_P-Td-3
Contract recorded in Recorder's Office - Record No. Page
If any portion of the residential structure or the land, not
income, describe e(1) acre that
of
irnt�ediately surrounds that structure is used to produce
the property utilized to prods ce ir>cone
Any other counties in which individual owns or is buying real property:
County : Township
•
h � , ; . the above statement is true, correct aid couplets. •
a � G/ Street n^^*E'� City, State and Zip Cod`
/Signature s he is to the
*Individual either owns or is buying uur� a contract that de the is to a
property taxes on { reside„ , or has a beneficial interest
•
. - FOR ASSESSORS USE ONLY - -
True (ash. . Assessed Haesteac
Value Valuation . Valuatio
Land not exee°^ing 1 (one) acre intr iately (1) o o Zo ° pZp��o °
surrounding rsidentia, improvements (2) //U//. o 0
Coder Total Lam 6—e c 2- e--o '%
STATE FORA1535'B(R31 8-10) TREASL'RFa FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.200A PRESCRIBED BY THE DEPARTMENT-OF LOCAL GOVERNMENT FINANCE IC 6-11-12t1
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 requites taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
•
F I L E benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.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 tools that will help county officials eliminate homestead fraud.
1 A ' PAR1' 1: PROPERTY INFORMATION
MAY -1 1 2011 Taxpayer Name Location Address
Willis, David Allen/Trudy D
508.LINCOLN
GIBSON COUNTY AUD TOR ' OAKLAND CITY IN 47660
8616
David AVYillis Iiii�iGU �Diiii�i�ii�0lI 111161111 iii�liii ill II.iLI IIliiBiilllil►�[�{giiii1 ICI
5069 S Lincoln St
OAKLAND CITY IN 47660-7659
IIIIII'IIIIIIIIIIIIIIII'I 'III"IIIIIII"I'I"'IIIII'I'IIIIII'll State Parcel Number Legal Description
'I
26-20-02-401-000.299-003 /BARRETTADD 1/2/3
eti
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.
- - - - I1tR I T4\YA1 R INEOR, IATION - -- --- --- -
Owl-1t - First Middle - 1 Last
w
Mailing Address(number and street,city,state,and ZIP code(1 f I Same as perrS-i;\ .
. -
Spouse First Middle ` 1 'Last
-- cL \ Pn - L `1 .`�k S
Mailing Address(Number adA street,city,state,and ZIP cod ) ` a as property address—\--_,,k (4R co(„o
o(JR S / Lve\CAD n l /‘ . 3.0,,_\-4, 3_,„_0\. c_.,-,-.* • , 4,lease specify in Part 4 below)
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
�I • ! •
PART 4: ADDITIONAL INFORMATION