Homestead_Cloin •
MATT ROAN!Mt.0121,4/0 IRr tL ti POEM TS-IA
...FIRMED BY MATT.BO1RD OF ACCOUNC.21:04 PltlaltIRED BY 111E
TO OFPARINffiNT OF LOCAL CalkTSNMENT FINANCE It
OWNERS
z,
Gibson County Auditor
101 N Main
PRINCETON IN 47670 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 eser for homestead fraud Ilomestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2IX9 requires taxpayers who receive the homestead standard deduction to serifv that they are eligible to receive the
benefit anti to provide additional identifying information necessary to allow county gmrmment to better monitor hanwsread
filings.This information will be kept confidential and ran only be accessed by authorized county officials.The Ikpanntent of
Local Goverment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Cloin, David D/Janesse N
RrI Box 153
3003
David D Chin •
255E 780 S State Parcel Number Legal Description
FORT BRANCH IN 47648-8003
II III I II I I III II II , I I I II 26-19-19-203-001.246-026 007-00635-00 INDIAN HILLS 45
a
r n nit nt u u f u r ut r ,1 r t ur D-27
•
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.
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
�Q✓ ar �en7 nc C/o LI
on,Address(number end street,city,state,and ZIP code) ❑ Same as property address
2 5 - E 7 fc7 5 jf L.?,A/,C A 1>Ci v 76 Y9
Spouse /��� First Middle �l O � Last J 5ie h�u le 1
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
2cc £ 730 5 Ft ,8 ter ne ,Z X/ 577j`/8
PARTS: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 I Si azure Date
i
� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDRlSTANDARD DEDUCTION
sram r«� s�r3 �t� i son�
Presrnbed by the Departrnen� of Loml GovertvrKxil Fuwnce
� INSTRUC710NS: See reverse side lor filing insbuctions.
9�e.., n� yn,ti 3 N -'. �� 5�619
�s::�'��v���'M� � x �;�r.�, �"";:;� �� ., °';t;Y�' _ _ nFlCan� srn�
� (we)
1(We) ocwpied as p apal pla� of residence the fo0owirg esaibed real property
/�
�t- : I� �':�
�
�j � I'� ''
JUL 0 3 2007
a Homestead Property T�c Gredit is hereby daimed:
❑ � M�e) ownM ❑ Pre buying under contract
�iave a benefidal mtarest in the entity Uiat is liade for fhe property tazes o� ihe property and that ams ihe property or is buying under a contraci
n 4ry'ug om m�trad, Fee Sirt�le awners reme
��`�:!
r�wp
H a1ry por�ion d �ha rasiAeritial s6uchne a the IaM nal m�caeding ana (1) aae thal
af Iha WnVartY Wf�d tn produce mmna.
�/ �—/ `�—
:own,
Remrd number � Pege
i7uestion. '
Reel properq � Mo6ile Fioma (I.C. 61.1•n
ua is usad b P�uce cxnme. desafie �ha use and G�n