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SLATE FORM!!.'rv11C/s-wn T EASUSER FORM TS-IA
APPROVED R Y STATE WNW Or ACITsNr'.9w MESRIBm DV TIC DEPARTAENT OF LrAAE r VTR$MOCT PNANCE IC 6-1.1 4:4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
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 e'er for homestead fraud Homestead fraud cau¢s higher Iaa bills for all:therefore.
HEA 1344 20N requires taxpayers who receive the homestead standard deduction to verify that they are eligible to rceene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.Ibis information will be kept confidential:rod ran only he accessed by authorized county officials_The Ikpanment of
Local Government Finance will use this information to create tools that will help county official',eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Smith, Cory G/Johsa
R I Box 339
Haubstadt IN 4763
3355 ��JJ
Cory G Smith
1345 W Wheatland Ct State Parcel Number Le2a1 Description
HAUBSTADT IN 47639-8762
1r1n11rn1r11nu11r1r1nlnitlntltlitntirltlnlrItltltiul 26-22-12-300 002.312-024 THE MEADOWS 6
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.
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Spouse First Middle Last
So�Sc� nn ;1-1\
Mailing Address(Number and street,city,state,and ZIP code) g1 Same as popeny address
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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 substantial financial penalties.
Owner I Signature�/04 Date
CLAIM FOR F{OMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
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�I(We) owned ❑ Are buyug unda mntrad GIBSON COUNTY AUDITOR
Have a ber�efid� mterest m the entily Ihat is liade for Ihe propetty taxes m Me property and Mat ams Uie property or is Wying under a conhact.
n Wy"cg m mntrec4 Fee Sirtryle wrnals rame
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I hereby certiTy 9ie above Sfaternenls are true. cartact and cmqlete.
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Tital value (16re 3 pks Gne n (8)
I f�ereby oertiy the above's We, oom#. ard Sier�ae wAs�wr Pam eigad
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vairyug eWm - Si�atae a1 n.#mr Dam signed
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20 _ Pay 20 _
Lesser aF 12 Homeslead
Valuation or 535.000 s
Si�a6ce of Audimr Dete sq�ed