Homestead_Tooley STATE FORM 53569(Ra/509) TREASURER FORM T5-IA APPROVED BY STATE BOARD OF ACCOIIS'TS,'009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-Lt 12-S.I
- tr `r. ;IM,;c rV NT NOTICE TO -10MESTEAD`PROPERTYc,OWNERS,
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
e^ uction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
auses higher tax bills for all; therefore, HEA 1344-2099 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 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.
` =:LLJss 4 ice !� ig : PRT, R,..O�>P ET r\f�i.\FOR.:I ATIO\:; .,, �& _ --1.C
. :. -.-;i =.
Taxpayer Name Property Address `` ' State Parcel Number Legal Description:
R 2 Box 72 eVY✓ / r
Jeffery P Tooley 26-14-19-300-000.967-00(✓ 6,003-00967-00 PT MV SE 19-2-8.57
Oakland City IN 47660 ✓✓✓ AC C-I
-
Complete and return to:
GIBSON COUNTY AUDITOR. 101 N MAIN PRINCETON IN 47670
�,..2 :2 a¢re ._ ;a:Y:PARTi2:.7•:a'XPXYER:L\EORM:aTIO\t7:.t .. __`y.....»c. '; r. r+ =1^'$°
Owner 1 First Middle - Last
�—FFr_ r t�tA t.9 1 --Fir)r) C t
Mating (number and street.o state and ZIP code) I
'^ �Iierfe as properly address
'Ca a9 y of 1Aeo-C _ d fl VIik�-� �D c,1-4, a c-/,7 6.1�-e�
Spouse First Middle - Last
Marling Address(number and street.ay,state and ZIP aide) Same as Pwe+iy address
Soda)Seauity Numbs(last 5 digits) Drivels License State ID Number(last 5 digits) Stae Other(please specify in Pad 4 below)
'I • '' ' ' PART 3h.CERTIFICATION' -
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or sheds 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 1 Signature Dare :•`. -
)
T=r':—_�,tt -'; . : 4 . : ent `2,,PART4 ADDITIONAL_ NFORNIATION, : , >^ - ---
AI
CIAI[,I FOR HofEffAD PROPERTY TAX CREDIT FOR YEAR 19ff.
SEE BACK FOR FILING INSTRUCTIONS ✓
� certify that on the 1st day c
I e) 2 V' 1L
i•+_rrh, 19_, I, ( le) occ ied as our pnnc1pal place or resonance the following described real
F- o�rty for which a I3orre�+°tea property Tax Credit is hereby being clainsi:'
are buyinq carrier contract QQ3 - bOQ�e�' 01D
have a beneiiIial interest in the taxpayer .
Prop.,ty Description. in `.fa. County ( �� i-sx �s-r -a Zcwnsh�
Taxing District (City, Tm.-n, Tcl- mship): C P•` �—
Par�°1 Iftiw -� I or legal description shown on tax statsr__rrt:
If buying on contract: Owners MITIO (fee sirmle owner)
Corr`sact recorded in P=wrder's Office I3o. _�_ Pa9 e
If any portion of the residential structure or the land, of a describe e(1) A and portion of that
i mediately sunvucris that structure is used to produce income
the property utilized to produce intone
. ..- County
;�ny other counties in wn)-ch 2xilividual. airs or 3-s. buyajig real Correct .o •
,,'f
�1�yI1( -v —a l�L� - - • • •
• .
• • _ -D
on the residence, or has a a .•- • _
- FOR ASSESSOR'S USE ONLY -
True cash. Assessed HaMestear
Value Valuation .Valuatioi
land not exceeding 1 (one) acre iraeciiatelY (1) /7o
surrour3ing residentia_ 1 i=o is
(a)
0t-r Land /-70
Tonal Land a I3) �--
Pasie°n`�ia1 7lmrwar�nts DwEllina (4)
Garage
Total (6)
(7)
To D=,, rents - Line (6) plus (7) equals (8) (8)
;p certify the above is true, correct, and �rplete.
I h��Y
Date
- ACTION BY nUDITOR
Date: - 7-
�.�ZOVed