Homestead_Wilkins Mit FORM e,.-01,a't54Yt TREA5tEE1 FORM—IA
APFR[VEO BY 515TE Bn5RD OE,YYYMLTR'W4 PERYNBED BY THE DEPARMEVE Q LIX:AL GOVERNMENT FINANCE in-id-rat
0
�County Auditor
11-N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
-PRINCETON IN 47670 Individuals and married couple.are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ner for homestead fraud.I lomstead fraud causes higher tax bills for all:therefore.
I FIFA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reeehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
\:, filing..This information will be kepi cnnlidential and can only be:accessed by authorized county officials.The Ikpanmem of
Local Government Finance will use this information to create tools that will help camty officials eliminate homestead fraud.
q �� PART I: PROPERTY INFORMATION
11
Taxpayer Name Property Address •
6B ,Cp1V Wilkins, Jerry W/Eula Belle
AvA 1 RI 13ox 83
t+t Oakland City IN 47660
1682 tv/�t
PUQtSQF
Jerry W/ E Tins
11063 E State Parcel Number Legal Description
Oakland City IN 47660-8652
26-13-13-401-001.02 006 003-01028-00 PT SE 132-91 AC
— li ltd lItnIilliti llulltnlnl•ullinittu•IuIiIIuuIIiIutll C-1
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 I First Middle Last
• r
3evrr � w ///�%rit. w//lords
'Ong Address(number and street.city,s e,and ZIP code) 2'Same as property address
s
1/O ( 3E /aoS otil(/H 7) e-l7y I & d/7e o
.
Sporg: ^^"P" ' `sez First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
_ _ sos
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 Signature Date
•
FORM HC 10 1979
Prescribed By Stale Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 192q
To Be Filed in Duplicate
Q�r'SEE
the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ ownedlO
❑ are buying under contract
❑ have a beneficial int[e�rest in the taxpayer
Property Description in /� County Township
Taxing District (City, Town, Township): �o
Parcel Number
If buying on contract: Owners
or legal description shown on tax statement:
61t . � r'/ - R i �
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:
hereby certify the above statement is true, correct and complete.
yf-- "CA (�� W12A� 4f 4 # to 50-14
'Siaoature Street Address
County Township
Zip Code
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 -
1
Land not exceeding 1 (one) acre immediate)
surrounding residential improvementg;UN 1 1979
Other Land
Total Land
Residential Improvements T
Garage
Total
Other Improvements
Tolmprovements - Line (6) plus (7) equals (8)
I I dby certify the above iA true. correct, ano complete.
signature of Assessor
True Cash
Value
(1) 1$—"—
(2)
(3) d G�
(a) /a DSO
(s) —0—
(6)
(7) — O
(8) /a s0
InlTna -
Assessed
Valuation
ISO
0-
J
Homestead
Valuation
,6--- /Y- 79
Date
Date: —/