Homestead_Barrett (4) STATE FORM 53569(8. S-ID) TREASURER FOCM TS:A
APPROVED BY STATE BOARD OF ACCOUNTS.2035 PRESCRIBED BY TILE DEPARTMENT OF ISICAI.CAVERNMEYF FINANCE IC 6-1.I-22-1.1
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 more beneficial,there is more incentive than ever for homestead(mud.Homestead fmud causes higher tax bills for all;therefore,
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to gone that they are eligible to receive the
•
benefit and to proxide additional identifying information necessary m allow county gmermnent to bener monism homestead
filings.This information will be kept confidential and can only be accessed by authorised county officials.The Deparmnen[of
•Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
- APR 2 6 2011
Taxpayer Name Location Address
C.J. Barrett, Donald W/ Barbara K
103 W Walnut ST
-GIBSON COUNTY AUDITOR - Owensville.IN 47665
6371
Donald W/Barbara K Barrett 110101I1)tiii 0I 110111011[I 01110101111011011_ii:ii i 01110ut_I 1011011010110111
PO Box 172
Owensville IN 47665-0172 - ° '
I1Iltllll1tttlt1Illllltitttl1ll"'lillI"iiliis�.i 'illIIiiiIillI State Parcel Number Legal Description
26-17-12-204-000.135-022 /PT NE 12-3-12.18 AC °
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.
--------- --- • PA' - —A,_._A ' • '!. A S-. . .
_..- First - Middle Iatt-—
. ,v /9 C rn 1.t) a`'k n e ._ 1 g• '6- TT
Mailing Address(number and street city,state,and ZIP code)- ` - ❑ Same as property address
. ,__‘ o bO ac1lle 3t�
S use First Middle Last
•V,arb G,r a ct__ { s‘ C'C`-4-
Mail ing Address(Number and street,city,state,and ZIP code) El Same as property address
(� gym/ 1m a (i &cutI ( e p u-flL aS .
.
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.
Own I Signature Date
PART 4: ADDITIONAL INFORMATION •
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