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- ACTIO(1BY AUDITOR • .
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'P.,_=0••Pri: R :0 ; eA:6Lkui ey_et . Datc: Li- a 3-Rii
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SLATE FORM!MP In I SwT MSA:tER FORM MIA
.VE0.aEn BY STATE if NROOM A'(Or.S13.vN ?MUD BY THE DEEARTNMNTOF LOCAL GOVERNS1M7 FINANCE MFI.I-Lit
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individual and married couples are limited to one homestead srandanl 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 1343-2009 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 Drammen! to better monitor homestead
ffilingga.This information will be Lept confidential and can only be accessed by authorized county officials.The Depanment of
Local Government Finance will use this information to create tools that will help cony officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Robb, John/Suetta K
3/O Ohio ST ®k
Hazleton IN 47640
56
John/Suetta K Robb
310 S Ohio State Parcel Number Le2a1 Description
Hazleton IN 47640-8905
I tlnilntlt llntiuliintIu lIlIlnllInllIlunlIlinnllnl 26-02-59-033-000.256-019 014-00256-00 E ENLG 138/139
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
®mg Address(number and street,city,state,and ZIP code) El Same as property address
310 5 . Okra ST �nz1-cToa, TA L/r) 90
Spouse First Middle /16� Last
SfliQ.rTA VIII( K
Mailing Address(Number and street.city,state,and ZIP code) ® Same as property address
310 s . OR:. S -r. PA2_LE o4, 3AJ t-176 40
-- — — 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 Al
PART 4:ADDITIONAL INFORMATION