Homestead_Clevenger (2) ctATE Font!Meg tR/Nw1 TRall;LEA FORM ta-tA
.\PIR(wED 01,711t IYt•RD OF.AMY(Rt\Tl bw ,LL Inn BY Till DEPMIMDIT OF LIXM.CMER M[AT ENANCE IC 6-I.I-r4.1
Gilson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than net'for homestead fraud.homestead fraud causes higher tat bills for all;therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional tden:tfving information necessary to allow county government to better monitor homestead
tilinte. this information will he kept confidential and can only he accessed by authorized county officials.The Drnanntent 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 Property Address
Clevenger, Benny L/Donna G
301 W Montgomery ST
Owensville IN 47665
6109
Benny L/Donna G Clevenger
301 W Montgomery ST State Parcel Number Legal Description
Owensville IN 47665
26-17-12-201-000.089-022 017-00089-00 OLD PLAN 37 PT
X
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Benny Lee_ Cieueoser
--
ng Address(nu and street,city.state,and ZIP code) - U Same as property address - - --
I__I �
3 ► Lit Thom ornsrc/ 3. Ocv +ehsco, I( Ln . 47�(QS
Spouse First Middle Last
D c Gale Cleoen<Oedc'
Mailing Address(Number and street,city,state.and ZIP code) Same as property address
"301 Wirnon " C�PC4 St OwersJ111e: Lin . 4E7C6(0S
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
PART 4:ADDITIONAL INFORMATION
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