Homestead_Murnahan (3) Cc
STATE FORM 53569(R3f410) TREASURER FOP •.IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC& ; '2-8 I
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS ° •
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
deduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
•auses 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 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.
PART1: PROPER A'INFORMATION ,
Taxpayer Name 6i. Pro ertr Address tst Slate Parcel Number Legal Description:
N
Richard Murnahan " 4 MAP.. SMITH ADD 15 PT
OWENSVILLE IN 47665
alo- l7-ol.yo31I-ao1. 2z'I-a�I
Complete and return to: f11�11[1[I DDDIII000ID1mlImIO¢oomi®III HU
GIBSON COUNTYAUDITOR, 101 N MAIN PRINCETON IN 47670
;PART-2:TAXPA1'ER INFORNIATION . • . -
Owner 1 First Middle Last
RioUnrw Piub Mf) q,n114 NaN
Mailing Address(number and street,city•state and ZIP code)
Same as property address
4 813 W I tv Iv- Si. OWE:.NS i"rtt f / NZ 4) 6 5
First Middle Last
/staffing Address(number and street,city.slate and ZIP code) Same as properly address
Social Seemly Nunter(lasts digits) Driver's license/State ID Hunter(last 5 digits) state Other(please 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 1 Signature Date
Spouse Sigma re Date Telephone
( )
°.! -,- ' - I -PART 4:ADDI'I'IONAL"ITNFORMATION ;
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