Homestead_Dewig A
' • STATE FORM 9569(43 I S-10) TREASURER fOtM TS-IA
,. APPBPFD BY STATE BOARD OF ACCOUNTS,IIM - PRESCRIBED BY TILE DEPARTMESI OF IOCALCAr9L\MEYT FINANCE IC 6.1.1-22-8.1
Gibson County Auditor • IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples am 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 hills for alb-therefore, ,
HEA 1344-2009 requires taxpayers wtro receive the homestead standard deduction to verify that they are eligible to receive the
. , �1 T T benefit and to provide additional identifying information necessar to allow county government to better monitor homestead
Lr filings.This information will be kept confidential and can only be-ace cssed by authorized county to bete officials.The Department of
Local Government Finance will use this information to createttools that will help county officials eliminate homestead fraud.'
PART I: PROPERTY INFORMATION
MAY 4 ZO11 Taxpayer Name Location Address
C. .N Dewig,Joseph F/Tracy C - '
• " 390E800S
GIBSON COUNTY AUDITOR • • FT BRANCH IN 47648
2657
JosephFDewg H IHIIIOIII ill IDMIIIDIIIl.IIIIIh IIfIIDII_III[IIIIII_II�II�IImmIIIIIIlIII
390E8005
FORT BRANCH IN 47648-8025 -
'IIllllllllll'IllllllIIltllIttllttllll�ll' II�IIII�II"l�"' State Parcel Number Legal Description
• tl"
26-19-19-204-001.337-026NDIAN HILLS 109
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
0 I - First Middle Last
\oseOn �Yarlr .---, • 1�evi\yJ
Mailing Address!number and street,city,state,and ZIP code) ' - ® Same as property s _
\\ _
Spouse First Middle Last
1 1 °X i/ l \1 1\ t 5k t (lc-- �/ e W_Ic\
Meiling Address(Numbh ehd ince6 city;smite;and ZIP code) - — Same as property adM T -- - - -
-
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 I Signature Date
- - —
CLAIAR F�R FEOAAESTEAD PROPERTY TAX FoRM �
CREDITIs7ANDARD DEDUC110N HC7o
s� r-«m sna cR� i sos�
Pre�ed by Nie Deperhnenl af Loral Gavermnenl Fom�w
INSTRUCTIONS: See reverse side /or filing instructions.
i(�'ie) � t�Fi� 19[ day�,8�,, 20_
I(We) ocwpied as av prm pal place o residence ihe foBowirg desabed real fw whidi a PropeAy Tmc Cwedit is hereby daimed:
�� M/e) owned ❑ Me buymg under cantrad aU�
Have a benefidal interesld in the entity Mat is liade fiw Me poperly f�ces m the property a�M tl�at ams Ne {9�@�pSrQQUy6Tg'u� Lt�WtracL
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naly po�tid� arthe r�der� sm,m,re w u,e Im�a ne n�c�dirg w,e (�) aoa mal:m�daldr enroiu�
d Ihe property util�d b prod�ce uimrt�e.
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ia used to produoe'rnmme. drsn�e Ihe use �d puUOn
-±!?+ Y"ASSESSORUSEOpLY " �' � ; � �.T' TRUETA7C � ASSESSED VALUE �F106ffS7El1D` � � { v� MON�tESIDBiML�i+%'�1�'
<. � eti�* YAUIEi ?AT;100XOFTIV i e'VAUIE �a �tVALIJE "p�`��+.
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LarM rrot e�rg 1(one) aae imredia�ly :z , i SE��� �`?`n.�'° ^`3'� �'��� '
surtoimd'agresidentialimprovements. (�) �, ���;�>h�,���'��.�ir5��r°S��a'i
Otl�er lard (2) � ? v' � a �: -
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TU� land (line 1 pkulu�e � (g)
At �: a e s-'� A':{s!�
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Resdential'vnprovert�ent5 or Mnuafy �6� �4� : a � �'� .,.�"'• � �aii 3- -'��.."�,£.z r•,.
AssesSed Moble / Alanufa�taed Hart�e � �.-.cr � x ��+x� rz s�°=
s� f.�r r"j,t•��?"�-�`�` No-
��e (5) :i �� a �,� .,''"s+�u,,,3 ' j �`T,#7+��
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TUaI cnprovert�ertLS (�ure 4 throuyA Ene 6) (7�
Tdal value (!ure 3 pha 6ne n (g)
I hereby certify ihe above is true. carte�d, an0 Si9r�mae ofAss�aor Date sigied
complete.
�M�6 a�an - Sigrm4ue of Ndtu Dete si�ed
... , . . . . ��.�... ��
20_Pay20_
Lesser of 12 Homestead
V�uation or E35,000