Homestead_White (6) tlATE FORM 53?1 1lt.+, TILIASCIER FO/01 MIA
APPP.m'FD BY CI Mt En10.1301 AM RL1+.rynn PR/3MM)BY THE BFPARtt4t(F LOCAL nOtTAV.NrTl FINANCEICVI.I-L-1.1
0 County Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
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 eser for homestead fraud.I lomestead fraud causes higher tax bills for all:terefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recebe the
benefit and to provide additional identifying information necessary to allow count'government to better monitor homestead
tiling, This inthrtlation will he kept confidential and ton only be acrecsed by authorized county officials.The Ikpantnent 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
_ White, William J/Janet S
R I Box 205
Oakland City IN 47660
4768
William J/Janet S White
R 1 Box 205 State Parcel Number Legal Description
Oakland City IN 47660-8419
III I I n I I I I I I I I I I I I I I III 26-13-26-400-001.016-006 003-01016-00 PT SE 26-2-9.46 AC
o
t tat r ru nr u rs te nt t n tot C-1
5
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
ice , 11 :Pr `3: W it /TE
- -
g Address(number and street,city,state,and ZIP code) EyJ'Some as property address -- __ -- — - -
33a/3 5, sT,¢T-E: 104D S7 OAkLA-AID ei ry =AID;AM/A Y766a
Spouse First Middle Last
TA Al ET S. W 21,7- E
Mailing Address(Number and street,city,state,and ZIP code) El Same as property address
32/3 S. Sr,,Qre iKos-D 5-7 OAkLAIVD CO—y, ,t./tJ / ANA L/7660
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 Signature /t Date
•
FORM HC 10 1979 To Be Filed in 0opliwte
Prescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 IT /
SEE BACK FOR FILING INSTRUCTIONS
Q- f �. �iY � 003 — a 1st day A f
(We) V/� -� • certify that on the 1st day of
t arch, 19_ —� I, (we)66-ccupiecUas our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I. (We) E9 owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in %,untX Township
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name 1fea simple ownet)
or legal description shown on tax statement:
Contract recorded in Recorders Office - Record No. Page
If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that
structure is used to produce income, describe the use and portion of the property utilized to produce income
Any other counties in which individual owns or is buying real property: County Township
NONE
®hereby certify the above statement is true, correct and complete.
Street Address
.��
city. State and Zip Cade
Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
True Cash
Value
Land not exceeding 1 (one) acre immediately
surrounding residential improveme is
Other Land F (2) —,9—
Total Land (3) ;23o
Residential Improvements >.fav 2 '_q!9 Dwelling (a) y Y40
,•.._
%`// rage (5) d
r
/C�tal (6)
Other Improvements AUDITOR (7) — �—
Tr,*-'- Improvements - Line (6) plus (7) equals (8) (8)
1 O'by certify the a e is true. corre and complete.
Signature of Assessor
A TION BY AUDITOR -
A
Assessed
Valuation
*-lf /10
i
Homestead
Valuation
Z--/8 —
Date
Date: Z= r X17 9