Homestead_Whitaker Sl.AIE I OR,M: WIL/wl MASUrtR FORM rl1A
APPMn'ED BY sTAIL RINROnf Arnt'it_!nw 11S-YRInm BY Mr DEPARTEVrOw LOL'SI CAN?LYY.R.T MANCE le.-r.I--rJI
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 am eligible to recent the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing,.This intnlmation will he Lept confidential and can only be accessed by authorized county officials.The Ikpanment of
Local Government Finance will me this information to create txvls that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Whitaker, Douglas W
Hwv 57 North
Oakland City IN 47660
4321
Douglas W Whitaker
10964E 125 S State Parcel Number Legal Description
OAKLAND CITY IN 47660-8643
' l l I I I I I I I I I ' I I I' ' l l I 26-13-13-300-000.537-006 003-00537-00 PT NE SW 13-2-9 17.592 AC
r n nr r nt a nt n tr nr tt u n nr u I II C-1
PART 2:TAXPAYER INFORMATION
Owner I First Middle _� Last
Cocks la 1 Gavin e hg Addre (number and street,city,state,and ZIP code) - �J'Sante as property uddres
/o?Oy E ases s de.KIa.4dC//r , , 1/7 01
{
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 dieits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sex
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 • she may be liable ba' t . es and substantial financial penalties.
• .ne Signet/ Date
•
� CLAIM FOR HOMESTEAD PROPERTY TAX FORM
YEAR
CREDIT /STANDARD DEDUCTION HCIO
State Form 5473 IRS I4-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
V %t'/��Q�tX�L
(We) certify th on th is ay of a ch, 0
(We) occupied as our pnncipal pl of residence the following described real property for which a Homestead Pr eAy C it's re i
❑ I (We) owned ❑ Are buying under contract i �nn11
W, Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or isbbyiri AM IntraU.
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded
Record number I Page
? ic. PROPERTY,OWNED)B- k,MaIMANT.IN OTHER C6UNTIES MA,''.
r`t P,ROP,ERTY:DESCRIP ION5�= ;E.,
Cou ty
Township
Turin d' , town, I hi)
P nlan13�
Legal description
Is the property in question_
n`
TRUE,U
ASSESSED.VALUE
eal property ❑ Mobile Homo (I.C. 6-1.1-7) .
If any portion of the residential structure or the land not exceeding we (1) acre that immediately w unds that s cure is used to produce income, describe the use and portion
of the property utilized to produce income.
Al C 5F (3-2-9 7 - 7�
`t Z Q
AAT.S00 %'OFTTV
i.VALUEI`'v'
? ic. PROPERTY,OWNED)B- k,MaIMANT.IN OTHER C6UNTIES MA,''.
County Township
County Township
hereby certify the above statements are true, correct and complete.
Signal.K of c imant
Address (nu street, city afe, ZIP code) Al
TERM'. ' 'cis -'0+3
- ASSESSOR USE ONLYr'
n`
TRUE,U
ASSESSED.VALUE
- _
HOMESTEADS
.rem +:«.... -
NON=RESIDENTL4t. n
`VALUE
to ,� s6 �sx'.
VALUE..
AAT.S00 %'OFTTV
i.VALUEI`'v'
..�.
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
P�`"
Other land
(2)
�,
Total land (line 1 plus line 2)
(3)
Dwelling
(4)I
=�+a : t
Residential Improvements or Annually'
Assessed Mobile I Manufactured Home
Garage
(5)
t
Other improvements
(6)=
j °�+'' '
2^r
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Dale signed
complete.
Verifying action - Signature of Auditor
Date signed