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STATE I rRM!J Vn1R_/■y+l MAW'S*FORM ta-IA
APPROVED BY StVE BOARD Of AfmsTS"no PRESCRIBED BY TIC DFPMn e.nf llCAtrovBRNItICT MANCE M 6-I.I.r-,.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sundani deduction.As the receipt of this deduction becomes
r more beneficial,there is more incentive than eser for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
HET l344--7009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.this information will he kepi confidential and can only be accessed by authorized county officials The Depanment of
Local Government Finance will use this information to crease tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
—, Brink, Bruce C/ Lois Jean _
410 N Main
Princeton IN 47670
1933 1 �
Bruce C/Lois Jean Brink 9 tog pp Qid !V 1/
t
410 N Main State Parcel Number Legal Description
Princeton IN 47670-1561
IElrrlluilillrElrrrlll 1111111111 IIIELEIELrrlrhl 26-04-13-400-000.104-018 010-00104-00 PT SW 13111191.52 AC
/
Mailing Address(Number and street,city,state,and ZIP aide) ❑ Same as property address
Ag6 b led/ f- 41 Al- 12o. Po'. itz-1 P/ rekA- .gin //746o-
PART 3:CERTIFICATION _ "r -.r—"1"-:----'_:--7-_t--_,t.--_L7_,,ry, . - - -
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 sh may be li..I- for back taxes•.;yi .ubstantial financial penalties.
-
owner I S Date
PART 4:.ADDITIONAL INFORMATION
2-�