Homestead_Parke (3) SLATE FOAY.1M1112 rw.t 1RFASUI R FORM 31a
APPPmED BY STATE If Ils.RDOf.AT(R:%Ty!U Punaw BY 7111:DEP n 4T(i Ln1A1.GOVERNMENT FM:ANCEw i.1--22a.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 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 recent 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 Department 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
Parke, Monty K/Kenya D /
Rr I Box 302
Oakland City IN 47660
1870
Mon/Parke
(
'12087 Base Rd M State Parcel Number Lezal Description
OAKLAND CITY IN 47660/8479 47660/84_7 9
26-14-07-400-001.497-006 003-01497-00 PT W SE 7 2 8 300 AC
`I I I t It II nI I a I I tat I r n I I tat IIF F Ili It I F I F I n I I C-1
__ _ __ __ ___ _
_ —__ _ X ____— __ - --__ _-
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.
PART 2:TAXPAYER INFORMATION
Owner M --{{-- First 1� Middle Last
oN la)/ l \ pA rk-e-
Tg Address(number d street.city,state,and ZIP code) [Warne as property address
/3-087 E efise _ 1734€1, 0A-1c1i4tid 6;7 _Ti) 97e60
Spouse First Middle Last
reN774- C Vnr/�e
Mailing Address(Number street.city,state,and ZIP code) Salve as property address
/.2-O 87 / egg_ (o4-� / CA-l�( 4 C, `, TAI y7 o
--- - _ -�--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 Igo / �I� Date V
.
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION Hcto
Stall Forth 5173 (R614-03)
Prescribed by the Department of Loral Gmmmmma Finarve
INSTRUCTIONS: See rewaraa aide Ar MV kx&Lvd0m
I (We) 1 g - certify that on the 1st day of M rch, 20
J 9 property p.FtJ&.� el Y —
(We) occupied as our principal ce of resid e f lowing described real for which a Homestead Pro r it b daimed:
❑ 1 (We) owned ❑ Are buying under contract �!
' Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the properyo�isb�yingrSfi�er a contract.
-s-
�cx=v�.a`1`r .. CONTRACT. RECORDEDii.(-. ,�?.'-'.,K`,TSt'r"'3a'2;;*•"„ii
11 buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
rip ROP.ERTY;OUMEDBY CLAIMANT 114bTHER'COUNTIES,v1.A� ?%p� 79 i zFM W-Wsi? 'p
County
TIO _.- 9-,..
Krn9PROP, ERT .Y�DESCRIP N:r?''��'- s�'�'� v+,..:- iY •+`_�['�.?--- .�z"i,�44z_,.<ri-
County
hereby certify the alcove statements are true, correct and complete.
Township
Teeing district (city, town, township)
P yo r
VALUES
%C. <...... 'n:.p
Leg
sc'ti rty in question:
rope
❑ Real property ❑ Mobile Homo (LC. 6-1.1 -7)
«My portion of &JR t structure or the land not exceeding one (1) acre that immediately surrounds ediately sur that structure is used to produce income, describe the use and portion
Pro perty dq1 VCJ
rip ROP.ERTY;OUMEDBY CLAIMANT 114bTHER'COUNTIES,v1.A� ?%p� 79 i zFM W-Wsi? 'p
County
Township
County Township
hereby certify the alcove statements are true, correct and complete.
natur f ant
6 dd ( street city state, ZIP co'-dd?e)) 01qk1A A4 7 61
FAIN
'y'xt'ASSESSORU EONLY y - "
-TRUE TAX.1
ASSESSEDVALUE
"AT�100Ye
+HOMESTEAD
'` MON- RESIDENTIAL
-'��
- ;j°yx'.- 23Ti,+.x �
.rVALUE's1i
ti. _..., ivy?
_OFTTV=
,'.i
VALUES
%C. <...... 'n:.p
v�� - VALUE'S '��
er'.+''.�.
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
S A
Total land (line 1 plus line 2)
(3)
'Residential
Dwelling
(4)
T:
Improvements or Annually
�'"•`�
At;anaed Mobile I Manufactured! Hero
Garage
0
151
� �"Ti�:
-; , -�' �'.'^ ,
�,.'t...'.t�
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line T)
(6)
1 hereby certify the above is true, coned, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
r. ."
ll""P "�''i.3r x# = rSTANDARD:DEDUCTION ALILOWANCE? ;: —� =.¢{
20 Pay 20_
Lesser of 112 Homestead $
Valuation or 535.000
Signature of lwdhor Date signed