Homestead_Wheatley (2) STATE 100.515''•'IC Jr f•NI TCFASUHI FORM'3.1A
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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 ever for homestead fraud.Ilottlestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe 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 M accessed by authorized county officials_The Depanntent of
Local Government Finance witl use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Wheatley, Richard A
RI BOX 111 F
flaw:. HAZLETON IN 47640
•
1
1 , Z I
Richard A Wheatley
RR 1 Box 111F State Parcel Number Legal Description
Hazleton IN 47640-9310
I I I I III I I I I I I I I I I IIlt I rat III set I 26-02-47-190-000.703-017 009-00703-00 PT LOC 190 13-1-101.05
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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 �1 Middle 1 Last
PIC-1AR D / y ' U!tLi�t LEY
ion,Address(number and street,:ity,state,and ZIP code) ® Same as property address
ben 7 A). set E f✓AZ t670,4 dc) yio o
Spouse 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 Pan 4 below)
- i
_ _ sms
- PART 3:CERTIFICATION - - -- --v� ` -- ----
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 ignature Date
Spouse Signature Date Telephone 1/ l
PART 4:ADDITIONAL INFORMATION
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CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
\ CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R215 -92)
INSTRUCTIONS: See reverse side for filing instructions. t -� V n
` _ -- • . /�CUTICl/�I1T1/1 \1'CTIITC \tC \T - ... i N
11 ' r 0 - A 1
(We) certify I" .ilat tld:33ptlf March, 19
e) occupied as our principal place of residence the following describe eal..property for which a Homestead Property Tax Credit is hereby claimed:
�, I (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 owns kitpropertq�or. +s iiu rid undegEkltract.
t, d
CONTRACT RECORDED -
If buying on contract. Fee Simple owners name
Recorder's office where contract is recorded _ Record number Page
' e.- PROPERTY DESCRIPTION I - `
County Township
Taxing di riot (city. wn, town ip)
Pa I numb q__,,,, Legal description
If any portion of the residential structure or the land not exceeding one (it acre th im ediatey surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
t cc190 t 3 =I -gyp •'�l -1 R`C
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
eby certify the above statements are true, correct and complete. N
0
Sign r oI claynant ,
M1JL"`WI
t. city. s1aV
cod
\ 7
ASSESSOR USE ONLY -
TRUE TAX
.VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
*at Audito ate ig d
I
Other land
(2)
Total land (line I 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 jobs line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE '
19 —Pay 19_
Lesser of 112 Homestead
Valuation or S2,000
S
*at Audito ate ig d
I