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Homestead_Drury STATE FORM 53569(8318-10) TREASURER FORM IS-IA APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY TILE DEPARTMENT OF LOCAL GOVERNMENT FINANCE 105-1.1-22-8.1 1MPORTANTNOTICE TO.HQ'IF,STEAD PROPERTY OWNERS . • 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 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 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 homestead fraud. i PAR 1• PROPER YINFO'VATION- ;. Taxpayer Name Property Address State Parcel Number Legal Description: Lee M D , 203 N SCOTT ST 26-18-07-101-000.141-022 PT NW 7-3-11 .405 AC O WENS V ILLE IN 47665 Complete and return to: I111hIDfl1000fl001111ffllu11[1I0110u1®MIDIM ll GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 PART 2: TAXPAYER-INFORMATION' Owner 1 First Middle last LEE Nl-I CA-Ac EL Du.Rks Mailing Address 1J(number l{and stet.city..state a nd ZIP code) property Fq.Same as address N . Dwe,na/ ■ % i 1i Spouse First Middle Last Mang Address(punter and street,city,state and ZIP code) ,IA ime as 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 maybe liable for back taxes and substantial financial penalties. Owner I Signature Date • PART 4:ADDITIONAL'INEORMATION s FIT ED OCT 2 4 2013 • D V-1-)hi el )( GIBSOCOUNTY AUDITOR