Homestead_Hillyard S TATE FORM'IY.IR_ 49 TRFASULra TORY ta-IA
▪ RxrIMPORTANT NOTICE TO HOMESTEADTP PROPERTY RO14 OWNERS
GibS0l1 County Auditor ,
107'N Main
\ FRINCETON 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 homestead fraud causes higher tat bills for all;therefore.
HEA 1344.2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receise the
benefit and to provide additional identifying informaton necessary to allow county government to better monitor homestead
filings_This information will he kept confidential and can only he accessed by authorized county olfcials.'fhe Depanntent of
Local Government Finance will um this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property'Address
Hillyard, Michael
RtDos Gta
Oakland City IN 47660
3282
Michael Hillyard
R 1 Doe. 151 A State Parcel Number Legal Description
OAKLAND CITY IN 47660-8549
llfnllnrftllrnllnllnrinlr rinlnlnllrin rlln lltll lltnl 26-20-15-300-001.760-001 001-01760-00 PT N SW 15391.00 AC
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 1 ' Last\A,�`�Ikdx,{1 A(1�(10'(\i \ \\ ord
•hg Address(number and street,city,state,and ZIP code) Same as props dress
h''u E Sty' , Vinci 1 o 8 06L10,11(1 (14, Tn an ot. UJ 1.O b
Spouse First Middle Last
PO),(\i) N\ C_6e_ \\\\\ osa
Mailing Address(N ber and street,city,state.and ZIP code) p Same as property ad mss
— �— -----�
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
CLAIM;FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R614-03)
Presuitied by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
FORM
YEAR
I (We) t 1 V kit, rs" X &LZ certify that on the 1st day of March, 20
c
I (We) occupied as our principal �Iace�f residence the following described re 9(�roperty for wNirh a Homestead Property Tax Credit is hereby claimed:
Q I (We) owned ❑ Are buying under contract
elave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
��etkxi CONTRACT, RECO
If buying on contract, Fee Simple comers name
Recorders office where contract is recorded Record number Page
'W"� ''i*'T PFCOPERTY,,DESCRINON.
t -. I '
County
Tomm1hip
T
wnship)
Parcel number
Log on
Is the property
VAL
Z-1 -N-, 4 LI Q
Land not exceeding I (one) acre immediately
Iuesuon:
all property ❑ Mobile Home (LC. 6-1.1-7)
If any portion of the residential me or the land not exceeding we (1) am that immediately surmunds that structure is used to Produce income, describe the use and portion
of the property utilized to produce income.
surrounding residential improvements.
;nT'OkOOERTYiOWNED;BV,CLLMMAtMIN'OTHEFCCOUNTIES
County
Township
County Township
I hereby certify the above statements are true, correct and complete.
Signature of daimen t
(number and street, city, state, ZIP code)
t ?I
-TRLEXWzP
ASSESSED
—HOMESTEAD
NONA ESIDENTIALW,
$
jkj-j?nRF Tv�
VAL
Z-1 -N-, 4 LI Q
Land not exceeding I (one) acre immediately
Date 7L-
surrounding residential improvements.
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
k.,:. w,
"0
Residential improvements or Annually
Assessed Mobile / Manufactured Home
Garage
(5)
!O)Wr improvements
(6)
Taal improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correa and
Signature of Assessor
Dam signed
complete.
Virifying action - Signature of Auditor
Date signed
nP—,,5STANDARD DEDUCTION'ALLOWANCEk
20_Pay2O_
Lesser of 112 Homestead
$
Valuation or 535,0
Signature of Auditor l
Date 7L-