Mobile Home_Linxwiler (2) c.—..----A. tlil'fORMalw+,a_hell TAV3ttfl1OP.M}}1A •
APYMAIDoy 5TATLMARnnrnm"XwIS 979 PILRNBED BY THE DEP IMENT. r LOCAL novarnMrtfrrINANCE M bIt 4.24.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO'HOMESTEAD PROPERTY OWNERS
PRI'''ppplllyyy���'^^��F^��TT� `I N 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this d u n becomes
■ p L E more beneficial,there is more incentive than eser for homestead fraud.Homestead fraud causes higher tat bills to alts refore.
gp y 1 HEA I3-l4-2009 requires taxpayers who receive the homestead standard deduction to verity that they am eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
tiling. Ibis information will he kept confidential and can only be accessed by authorized county officials.The Depanalent of
APRDeal Government Finance will use this information to create tools that will help county(Addis eliminate homestead fraud.
7 /0)0 PART 1: PROPERTY INFORMATION
_ Taxpayer Name Property Address
#4'C/ eg--c, Linxwiler, Rollin
GIBBON COUNTY AUDITOR � t
TIILeIiDffl:,thn
Patoka IN 47666-9510
111111lnrltlltlllltltlltrlrltrtltltrtt111111tllttttltlttttlll ( 26-420-00242-O2 993 Clayton
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
p�� f / LIn � Lti1I€ r
*mg Address(number and street,city,state,and ZIP code) _ ❑ Same as property address
0 5 (tiJ. V,v�4 �,� 4--) do . i/ 7 6 to 6
Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sex
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 eliuible 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
Spouse Signature [}ate Telephone
)
PART 4:ADDITIONAL INFORMATION
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