Homestead_Moore (7) STATE FORM 5350(PJ t610) TREASVRFA FORM IS-IA
APPROFF.n BY STATE BOARD OF ACCOUNTS.2W9 PRESCRIBED BY THE OE➢ARIHE•T OF DUCAL cOVI..3MEYT Ft a IC 61.1-22-.1
Gibson County Auditor 'IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101.N.Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
Princeton,IN 47670 mom 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 are eligible to receive the
• FILET)ILET\ 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 konwstead fraud.
' PART 1: PROPERTY INFORMATION
MAY 13 2011 Taxpayer Name Location Address
C J.n Moore, Gerald L/Marialisa A
612 W Brummitt ST
GIBSON COUNTY AUDITOR
Owensville IN 47665
1918
Gerald L/Marialisa A Moore IIl�l�llla III .II II IIIIII�I III0111I�I01111 _111110111 II�II8ILILI�II�I'III
612 W Brummitt ST
Owensville IN 47665-8778
'11Itlliillilllitlltl�tlllllllirllllltttlllllllll'illll�'ill�'�II State Parcel Number Legal Description °
26-17-12-102-000.359-022 /BARKERS 2ND ADO 4PT -
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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 INFORAL4TION
First - ° Middle Last
��Lrcic� L ooyre___
Mailing Address(number and street,city,state,and ZIP code) Er Same as property address
Spouse First • -Middle �(� • Last
I
! drtG1l SC. 1� I � 0orc,
Mailing Kddre s(Number and stredC city,state,"and ZIP bode). - - - - _.__.—.__ Satucas property address —
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 gnature Date
•