HomeMy WebLinkAboutHomestead_Stetter STATE MOW 33569 tie MOT TREASURER R J4TSIA
AMWLTTD BY STATE BOARD 6 ACCTNYT5.209 PRESCR®FD BY THE ARTME TCF LOCAL GOYE,RI.\EAT FINANCE IC 6-1 l n-I I
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
'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 ever for homestead fraud. Homestead
fraud causes higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the
homestead standard deduction to verify that they are eligible to receive the benefit and to provide
additional indentifying 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 I: PROPERTY INFORMATION
Property Address(number and street,city,state,and ZIP code)
ods- e . .
State Parcel Number
do-/07-d 2-I Q 0c ao/ 90-Qa e
• PART 2:TAXPAYER INFORMATION
Owner rI/II� First Middle ,Q Last
MC St • d�/_ l -1itJ
Mailing Address(number and street,city,state,and ZIP cod I I Same as property address
Spouse First Middle Last
is.Address(Number and street,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sure
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
INSTRUCTIONS
® Mvf L r
CL�LIh9 FOlt HOAAESTEAD PROPERTY TAX
CREDI7/STANDARD DEDUCTION
sm� r� 5�r3 � i sus�
Pra�bed by Ihe Deparma�f oF Loral Gouermieri Faanae
INSTRUCTIONS: See reverse sde (or filing msbvctions.
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I(We) ocapied as aa pr"v�dpal plaoe of ' toAowirg ewbed real proper�r whid
i p^r�) ow�a ❑ ae wyo,y �„aa d
, Have a bercfidal citerest m the entity thal is liade for the poperty tazes m Ihe poperty and
rc tuy.g om m�aau Fee sir�ie oMners imma
Rxadds of6ce whae mriaC is recadad
FORM '
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Paeoel nmiber _ \� Legal desoiptim I tha �in quesfim:
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H airy pdtion of the BsideNial struchue w the lad na1 ecceemng one (1) aoa tlat inrted�ely sv�ma� Ih� �re ia usatl b pmAun nmrna. tlesvbe Ne �na md pwOm
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Caunry TornsNp Counry To.vnship
I hereby teAify Me above sfa6enrnfs are true, corted and tortplefe. ��re d damalC .
(nu�er ad ffieet �Y. �m. ZtPoode) �
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- �" x� : TFgJETAX � AS�VALUE �H01�S7EADi ;L v'�MON�S(DII�fiIALt�;;�-�
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siaraaMiq residential imp�oMemenh. ��� ���� �s ��,i.�;?y '�. .�$�xji�F ���
Otl�a land Z . . •. .�; ., �
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i � ,it tit�q°�, � ��e� �a a i,� �'�;�
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Resdential'vnprvvert�en5 aMrwaly '� +'� � �.;`sn�4• �;R E�X..'�';. ��.�.
0.ssessed Abade / Afarafe�aed liome ��� � ��t y :� f s�ue �
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OM�er imprnen�ents (6) r�-.;!':
M�
TUeI cnprovert�ertls (!ere 4 tivough 6ne 6) �7)
TUeI value (1'nie 3 pha 6ne � �g)
I hereby certify the ahwe is W e, oortect. and Si9r�ae ot nss�aar Date signed
mmpkte.
Vaiyuq eClan - Si�sCae aF Audtar Da� sg�eE
' � �' STIWDARD DFDUCTION ALLOWANCE�. a . ' �: tii � `` �,� `« :,��
20 _ Pay 20 _
Lesser of 12 Hanestead
vatua6on or f35.000
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Si�ue ot nu6mr � s�