HomeMy WebLinkAboutHomestead_Dame STATE FORM!I!tS n(_'/SWI TAE'LNIFB FORM 11
APPROVED BY STATE rOSRDor MXnNTS.bn PRISCRIBW BY nil DEPARTMENT OF LUCIA WV LYMUr FeascE IC..I.t-r..1:
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple.arc limited m one homestead standard deduction.As the receipt of this deduction becomes
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 verily that they are eligible to remise the
benefit and to provide additional identifying infonnanon necessary to allow county government to better monitor homestead
film�n_This information will be kepi confidential and can only he accessed by authorized county officials.The Depanment of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Dame, Barbara L
—• R I Box 95 ///
llazleton IN 47640/ -110 5
Barbara L Dame •
2388 E Dead Level Road State Parcel Number Legal Description
Hazleton IN 47640-9272
I I I I III I I III I III I I I III 26-02-27-100-002.712-017 009-02712-00 PT NW FRAC 27 1 10 7.338
r n ur t urn ru r nu r nt n r u t u ur t 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:TAXPAYER INFORMATION
Owner I First Middle Last
PR i•"' ,~ ,- L G ,cam D
aping Address(number and strut city,state,and ZIP code) El Same as property address
(Q 3 9S 5" J)e c-c Level c /i c-, 7iT T—A/ Y7 c'u
PART 3:CERTIFICATION
Each undesigned.certi5es,.un der-penalty,ofpetjury,.that.the-above.and.fnregoing.information.is.rnte.and.correct.and.that.he.orshe.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