HomeMy WebLinkAboutHomestead_Ellis (3) STATE FORM S3SW(YJ161a) TREASURER FORM TS-IA
• APPROVED BY STATE BMRDOF ACCOUNTS.YM PRESCIUBID BY THE DFPARMEYT OF LOCAL GOVERNMENT FINANCE 1e 611-222.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N.Main Street lndisiduals anti 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 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to receive the
• benefit and to provide additional identifying information necessary to allow county government to boner 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.
PART 1: PROPERTY INFORMATION
Taxpayer Name Location Address
_ - - Ellis, Kyle E
'l$tl1��® 9 2nd
Hazleton 855 FILE T IN 47640
Kyle E j('( 10 2011 II 10111-111111 III III 11 IIIIII1111111 v1IIlII]11111111111 II IIIIIIIIIII III IQ II
509 E Second ST
HAZLETON IN 47640
X11111111111111111111111 11il1llllllt II IIII1�IIlll1lt1111111 State Parcel Number Legal Description
GIBBON COUNTY AUO TTO�R 26-02-59-033-000.117-018/ PT MD 33 1-10.37 AC
.3
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.
Spouse First Middle Last
fi 'I±( reA),0a ALL', c
Mailing Address(Number and street,city,state,and ZIP code) 10 Same as property address
Cu q at sr a ero tJ i, )-I AZ L ET-0 f\i _)v LI R o
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.
•
FORM HC 10 1979 To Be Filed in Duplicate