Homestead_Whitfield STATE FORM 53569(Rn-09) TREASURER FORM TS-IA I
APPROVE!)BY STATE BOARD OF ACCOUNTS.2609 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1- 8.1
IMPORTANT NOTICE TO HOMESTEAD 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
fuses higher tax bills for all; therefore, HEA 1344-2099 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.
PART1: PROPER YIN OR,MIATION
Taaoarer Name Property Address Slate Parcel Number Leta!Description: --
Dee Ann Whitfield 412 Main 26-17-12-204-000.110-022 017-00110-00 PT NE 12-3-12.31 AC
Owensville IN 47665 CONTRACT TO DEE A WHITFIELD
Complete and return to:
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2:TAXPAYER INFORMATION
Owner I Fits! name last
/ ) e_e_ 4 l 4 (
yia JoU.H M 4-7tJ St B s3s
•
/
First Middle Last
Mailing Address(number and sbeeL city,sate and ZIP code)
Same as property address
Social Security Number(last 5 digits) Drivels License Sate ID Number fast 5 digits) stare Other(please specify in Pan 4 below)
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 's Date
(
PART 4:ADDITIONAL INFORMATION