Homestead_Cavett •
STATE FORM 53ta'iR:/ynl MASORA.FORM ZIA
APPROCED
HOMESTEADFP OPERTYcOWNERS t r
Gibson County Auditor
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one homestead Aanda,d deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tat 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 identifying information necessary to allow county government to better monitor homestead
filings.This information will be kepi confidential and can only he accessed by authorized county officials.The Depanment of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Cavett, Pamela R
C23 ______
Oakland City IN 47660
1673 •
Pamela R Cavett
12316E 275 S State Parcel Number - Legal Description
Oakland City IN 47660-7822
ltlnIlnrlr 11ut11u 11rrr1u r11rrltultlulrkntllr Il III 26-14-30-200-000.159-006 00300159-00 PTNNE 30-2-8 2AC
q ‘,../
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
P4 Jct._ 1< Cq v ( /
t•g Address(number and siren,city,stare,grid ZIP code) - - — [Same m property address - - - - -- - -
1134, S S . .). 7 5 s,
Spouse N I / Middle Last
`
/V o C
Mailing Address(Number and street,city,state,and ZIP code) ❑Sane as pmpeny address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
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..Fach.undersigned also understands that,.byclaiming.additional.homestead deductions — - —
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date
•
I•
0 D � �/� 9 ` CLAIM FG-R E�T�-aUD ;mirr,'7Y TAX =E IT FOR TEAR 19_ l
ZK FOR FI h'" Ia—
&" rnLiIO'a
i
cl
=ti=y `_'e= ea =.,a !=
(Y-) --:�2°...j' v :..5 ��Dcl DL.^°. GZ re - -nm.o ?-� += nlSrwing
chi= a �—^ =--� =Y Tax am= ^°'=s rte. y^ _� ?�'
in C--= y =�
r.Tf
y :.^e ati.7Q0_ °.L°S.i 1S =L' _,
•�l�r.^.ic33L]. °i:i`°._..: oP::''5 or S BN3z:� L'^.3 a rn ----a �,_[Ly.. -. •'II4idS L� =S 3y '-'u.9`
-� --mmS CD has a - = --st in .t.17-- .
:�. -3:.�. �-.°°.:;�,3 1 tom) z_--e 3.• r'` =—�'Y -.
`'a l-1.n
C2)
al �14
(4) —_
ice)
CD
nT::a-1—s (9) ta)
I :. °may r=. i.iy ism ate , y , a o
_ ,1,- of P =spa
BY -mlrR
-:
/
p7017a
%MUMM��N
%000/00/
����NIllq/ elW15
//N 7o
to 70
�/INNE�