Homestead_Moore (9)CLAfM FOR HOMESTEAD PROPERTY TAX
CREDR/STANDARD DEDUCTION
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I(We) ooapied as ow prmdpal plaoe of residence rg d real poperty fior which a Hm�esteadP,�f�J Tmc Cre18t is hereby daimed:
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Have a benefidal inOarest in Me entity Ciat is IiaWe 4w Ihe property t�ces m the poperty and Ciat ams Me`ProPertY.o!.is '� �raer a conaaa
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20 _ Pay 20 _
Lesser of 12 Honestead
^ . Vak�ation or S:i5.000
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SfATE .F.O.�lU15356?(Ri/&10)
APPRO/:u BY SfA'IE BOARD Oi ACCOU�TS, 3009
ni�suxm Fonni tsu
PRESCRIBED BY THE OEP.VtTA�1T OF LOCAL GO�'ERNMFNI'FlKrNCE ICbl.l :LB.1
Individuals and married couples are limited to one homestead standard deduction. As the reci ipt of this
deduction becomes more beueficial, there is more incenti��e than ever for homestead fraud. Homestead fraud
�� uses higher tas bills for all; therefore, HEA 13A�1-2009 requires taspayers who recei��e the tiomestead
ST.ridard deduction to verif�• that they are eligible to receive the benefit aod to pro��ide additional identifying
iuformation necessarv to allow county go��ernmeut to better monitor homestead filings. This iuformation
���ill be kept confidential and can only be accessed b}' authorized county officials. The Departm�ent of Local
Go��ernment Finance rrill use this information to create tools that will help counh� officials eliminate
homestead fraud. �
Taaoa�ar \ame
Kimbedy L �1oore
Coniplefe and return to:
pwnert r
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Social Sewiy NuMer (lazt 5 algle
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Sarne es propeny aEEress
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hacti untlersignetl certNes, UnGef penalty ot per�ury, thal Ne above antl foregoing infOrmation i5 We and correCt and that he or 5he i5 e
homestead standard deduction on this property. Each undersigned also understands that, by Gaiming additional homestead deductions
she may be liable for back taues and substantial financial penalties.
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