Homestead_Genung STATE FORM•)KIR/fWt mr suria FORM YIA
mon:fn RYSt tL&MaOOr sena Kn.zoo PtF3WOF7)BY TIM DFPMTNIMIT OF LORAL CMSSRNMRW FreascEa'Nbnal
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple,are limited to one homestead standard deduction.As the receipt of this deduction becomes
mom Homestead beneficial.there is more incenthn dun ever for homestead fraud. fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to teethe the
benefit and to provide additional identifying information necesary to allow county government to better monitor homestead
flings.This information will he kept confidential and on only he acceaed by authorized roomy officials.The Department of
Local Govcnsncrt Finance will use this information to create ttvls that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Genung, Donald W
804 S Lincoln
Fort Branch IN 47648
7923
Donald W Genung
804 S Lincoln State Parcel Number Legal Description
Fort Branch IN 47648-1720
11111111111111m1111111111111111111111111111$1111111111111111 26-19-19-103-000.894-026 /011-00894-00 LOWES ADD 30
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
DONALb t'uwYivE GE& unl6�
itAddress(number and street,city,sate,and ZIP code) _ - ---- j��'Same as property addles -- _-— -
Ro11 S Li Alm Al FORT PPAocli rAIO . X1`1 hU)2
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) El Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sae
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
0
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