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IPI. ra BY sr.rE p D DC NYV •nTS.n•r• eafS(NBmar me o[eNtT OF` LOKLLG LW!cs' FINN \CE W1H.L4A
Gibson County Auditor
101 N Main I a a a
PRINCETON IN 47670 Individuals and married couples are limited to one homestead atardzrd deduction. As the receipt of this deduction become-
more beneficial, there is more incemixe than exer for homestead fraud Homestead fraud causes higher tax bills tar all: therefore.
® HEA 1344 -I09 requires tncpa,en who reccke the homestead standard deduction an .erifv than they arc eligible to mcoc the
benefit and to provide aLlainional identifvim_ information nece,mry to allow county ememment to better monitor homestead
fitit.c. this information will be f.ryv confidemial and ran only he acecaed by authorized county. officials. The Department of
Local Govemment Finance xcill sex this mformaum to ethic tools that will help eomay officials Eliminate homestead haul.
PART 1: ' ,.
Taspaver Name Pruoerte Address
Simmons, Thomas L
6859 S 1675 1v
Griffin IN 47616
2144
Thomas L Simmons
6859 S 1675 W State Parcel Number Leval Description
GRIFFIN IN 47616 -9310
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y
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
Ownet I First Middle
Last
0 M OL -e-
rn m o nS
'sere Address fnumber and street, city, state, and ZIP code) Same as property oddress
G5'
Middle
Last
r
Mailing Address (Number and street, ciy, state, and ZIP code) Sane to; property address
Each undersigned certifies, under penally 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 (�
Mae
Y — /Z—/V
)
ADDITIONAL PART 4:
1
I