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Homestead_Whitledge STATE FORM 53569(P313-10) TREASURER FORM TS-IA APPROVED BY SIAM BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC611.1-22-8.1 .• IMPORTANT NOTICE TO HOMESTEAD=PROPERTY OWNERS 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 ever for homestead fraud. Homestead fraud 'auses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead s dard 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. PART!: PROPER Y i'FORMA ION Taspaser Name Property Address Stale Parcel Number Leeal Description: Randal J/Carlee A Whitledge 542 w SR 68 26-22-01-201-000.117-009 PTE 1-4-11 .27 AC HAUBSTADT IN 47639 Complete and return to: IIIIIIRB7 mIf1f111f11117fI1 Q�DI II IWWII�110�IIII��m� - GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 JIItLL IWWI 1 l In IIII PART-2: TAXPAYER INFORMATION -• • Owner 1 First Middle last R Rcu _ u1hi+� Mailing Address(number and street,Gry,state and ZIP code)) P �(/� 5 l a First Middle Last Mitt Al lIR W�1� 1 eli1/494Q/ MaLng Address(number and street,ary,state and ZIP code) VSama as address 54a u)S N Ug U�'x_ t I1 y1li39 . 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 1 Signature Date .. _ PART--4: INFORMATIOiN. ._ _ - FILED L q D ill NOV 9 ?111? _. c.�.n • GIBSON COUNTY AUDITOR CLAIM FOR HOMESTEAD PROPERTY TAX ' CREDIT /STANDARD DEDUCTION State Form 5473 (R215-92) 'i INSTRUCTIONS: See reverse side for filing instructions. FORM HC10 YEAR CERTIFICATION STATEMENT d r ) I (We) certify thatch the 1st day of March, 19_` II((We) occupied as our principal place of residence the following described real proobly for which a HomesteacWerg t4aat is hereby claimed: 'rI (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 o �5 the pr pe or buying',µer contract. CONTRACT RECORDED If buying on contract, Fee Simple owners name Recorders office where contract is recorded Record number Page PROPERTY DESCRIPTION County Township Taxing distri ct ('ry own, towns Parcel number _ O /fV\ Legal description 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. PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES County ITownstup County Town i I hereby certify the above statements are true, correct and complete. Sig a of daima, yj � f - J e 0 c'2v r /fJ� ( /�.C//l /d /- - Ad (n tuber a street city s • , IP oode vj !/ l /e/JH`O•"MMESTEAD ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE VALUE NON - RESIDENTIAL VALUE Land not exceeding 1 (one) acre immediately S residential improvements. 11 i Other land (2) Total land (line 1 plus line 2) (3) Residential improvements Dwelling (4) Garage (5) Other improvements (6) Total improvements (line 4 through line 6) (7) Total value (line 3 plus line 7) (8) I hereby certify the above is true, correct, and complete. Signature of Assesor Date signed verifying action - Signature of Auditor Data signed STANDARD DEDUCTION ALLOWANCE 19_ Pay 19 Lesser of 1/2 Homestead Valuation or $2,000 S 0ture of Auditor sign — ©�