Homestead_Winstead STATE FORM 53569(RIB-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1-22-8.1
IMPORTANTIfN.00rTICE T,,MNIESTE$AD 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. - -
' z.:•., , i iki, UUy_;q t, PAR I: PROPER Y' NFORMATION- .i. - 1
Tamaser Name Property Address Slate Parcel Number Leeal Description;
Brent A Winstead 107 5 THIRD ST 26-17-12-202-000.090-022 OLD PLAN 31 PT
OWENSVILLE IN 47665
Comp"'`and return to: IlifiIIU[I16fl(1101ID]1IMIth1111011]I1J01h]I7[1][11V11
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
• . a174 ? -: rffigtTAXP,AXER+INF,ORMATION i' =s ° r;'' . ' "
Omer I First melee a / / Last
Bien/ien/ AAron . 1/14.,15111.1d
Maitng Address(reanber and street city,s ate and ZIP code)
I I Same as Property address
_ - Ph d� 31Q UltWkL5u. ) 1 e \ 14 — --— --.
-
1
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) state Other(please specify in Pan 4 below)
Is
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.
Omer 1 Si . e Date
Irr I_ ,. ici _' I ' > .PAR,I AII9 1 .21 .4 TIOP �5 r Obi �L _ r - _•