HomeMy WebLinkAboutHomestead_Bradfield STATE FORM 53569(R'8-09) TREASURER FORM TS CAI
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY-THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-11"-8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
'..z\aduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
auses higher tax bills for all; therefore, HEA 1344-2099 requires taxpayers who receive the homestead
7" 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.
PART!: PROPER V INFORMA ION
Taxpayer Name Property'Address State Parcel Number Luca!Description:
James E/Suezanne E -AI M.:273 r,i9/4.G S'7j b r �\
26-13-21-300-000.054-004 002-00054-00 PT NW SW 21-2-93
Bradfield Francisco IN 47649 AC C-I D-6
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Complete and return to:
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
,PART 2: TAXPAYER INFORMATION
Ownn I Ant Middle Last
f1--11 / S gti l2 C SCA07:16-16
MaSmg Address(number and street city,state and ZIP code) r - as Rupert address
/ 10 10 S 75c /CAivej-sd..a �N Y7 , Sy
•
cp..,sn Arst - -- Middle . Last
\._)UEZ(kNhIE _ e1-12-A-6g77/ Sebtor/E-413
Mailing Address(number and street.city.state and ZIP code)
Same as property address
I 6 S 75o A'- 1-1--. �z t) cto/ property
11/7e, /9
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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 sub- -ntial financial penalties.
Owner I Signature Date
.
r . PART 4:ADDITIONAL INFORMATION
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