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Homestead_Hedges • j SIAM FORM t 3t iR`/'iO TRFASIAIR FORMS-IA AP/ROVED BY STATE nn,ROOrM Tt tS.bv.v P45IRIBF➢BY rim nFPARTHEVTOF LOCAL CArRRNEFT FTAFCE IC H.1-Del Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 101 N Main r Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes ll l I, more beneficial,there is more incenthe than ever for homestead fraud.liomesread fraud causes higher tat hills for all:therefore. �� J j 7 HEA 1?4-1-2009 requires tatpayen who rceive the homestead standard deduction to verily that they are eligible to tecehe the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filintw.This information will he kept confidential and©n only be accessed by authorized county officials.The Depanntalt of APR2 2 2010 Local Government Finance will use this information to create cols that will hap carom officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION `-yy) "e Taxpayer Name Property Address GIBSON COUNTY AUDITOR Hedges, Phillip A/Perri F pt NW 2028&Pt E NE 1928 5.23 ac Oakland City IN 47660 5641 _ • PhilIJ'. A & Perri F Hedges 12516E 200 S State Parcel Number LeEal Description OAKLAND CITY IN 47660-8117 I\,. . I I I I I I I I I I 111 I I I I I III 26-14-20-100-001.480-006 PT NW 20 2 8 8 PT E NE 19 2 8 5.23 ac \r r ur r ur a nr nr nr r ern r • . PART 2:TAXPAYER INFORMATION Omer I First Middle Last Ph II ; 0 t_ges �tg Address(nufnber and street city,start,and ZIP code) - --- - ------- ia Same as property address — — -- —— - 0 I 5f 6 c too S Spouse First Middle Last Per r I F I-Ied9es Mailing Address(Number and gift,city,state,and ZIP code) Same as p pent'address Ia516 E 026 S 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 Sign ure Date • • CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION State Form 5473 (R614-03) Prescribed by the Department of Local Government Finance INSTRUCTIONS: See reverse side far filing insitilcliot, . vl�' 4 FORM YEAR CERTIFICATION STATEMENT I (We) C, R-Z I Via" f, n certify that on thf%: 2,Oi I (We) occupied as our prinopal place of residence the foII44'ng descdbed real property for which a Homestead Proart ax Crag ishVev'd med: l(We)owned ❑ Are buying under contract IRON COUNTY AUDITOR Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract. CONTRACT:RECORDED If buying on contract, Fee Simple owner's name Rewider's office where contract is recorded Record number Page :PROPERTY DESCRIPTIOW', County Township Tao distri city, town, taco h Parcel number - Legal description Is the property in question: bD c) (�r­ cc VALUE-, 010.1 Property ❑ Mobile Home (I.C. 6-1.1-7) If any portion of the residential structure or the Land not exceeding one (1) aue that immediately surrounds that structure is used to produce income. describe the use and portion of the property utilized to income. /produce PROPERTY OWNED BYCLAIMAi4T[NbTHEKdOUkTIES' '--- County Township County Township I hereby certify the above statements are true, correct and complete. Si atur �pdress I, city, slate, code) fc- ONLY TRUETAX ASSESSED VALUE HOMESTiL46 NON-RESIDENTIAL s .j--ASSESSOR.USE VALUE AT.100%-OF.TTV- VALUE-, VALUE: Land not exceeding 1 (one) acre immediately ........ surrounding residential improvements. Otherland (2) Total land (line 1 plus line 2) (3) Dwelling (4) Residential improvements or Annually Assessed Mobile / Manufactured Home Garage (5) ,,. ,:: ❑ ;:. =..s . _ Other improvements (6) Total improvements (line 4 through line 6) :(7) Total value (line 3 pits line 7) (8) I hereby certify the above is true, correct, and Signature of Assessor Date signed complete. Verifying action - Signature of Auditor Date signed 20 _ Pay 20 _ Lesser of 112 Homestead Valuation or 535.000 S Audno, � Dalvited � I — i