Homestead_Ennulart STATE FORM 5)564(N 1610) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNT&M% PRESCRIBED BY THE DEPARTMEIT OF LOCAL GOVUNMEYT FINANCE IC 61.1.223.1
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 fraud.Homestead fraud causes higher tax bills for all;therefore,
4 T'HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to receive the
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.ecal Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. _
JUN 0 3 2011 PART l: PROPERTY INFORMATION
Taxpayer Name Location Address
Ross, Sandra J
411 S Mill
GIBSON COUNTY AUDITOR
Owensville IN 47665
6390 IIII 11 11
Russ E Ennulat I II_I�I111 III �IO (� III fillK �III_Iim II�II�II_IhIII_I_1JUl1I II�II�II�I�II�I II
411S Mill St
OWENSVILLE IN 47665-9297
1111111111111"1111111111/2"11111111911111111.9111'111111111111 State Parcel Number 1111111111111"1111111111/2"11111111911111111.9111'111111111111
26-17-12-204-000.407-022 /PT NE 12-3-12.46 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.
Os...-. I First —^_. Middle .. Last
S s GfiC.tve rtrJ u I c
Mailing Address(number and street,city,state,and ZIP code) Same as property address
4H S Mi l � St
Mailing Address(Number and street,city,state,and ZIP code) 0 Same as property address ,
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
I I l l I I I I I Slate
PART 3: CERTIFICATION
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 1 Signature Date
( )
PART 4: ADDITIONAL INFORMATION