Homestead_Kates I.
SEATS FORM!WIR:I YMI flEANtfR FORM TIA
ArrROCEB BY SIAM MAROCK ACCOUNTS.ors PLES[AIBm BY TIE DEPART.TOF LOCAL GOVERNMENT FINANCE WsI.I-•_4.I
101 Nn County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
di more beneficial,there is more incentive than es er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2000 requires taxpayers who receive the homestead standard deduction to verity that they are eligible to recene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create owls that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
• Taxpayer Name Property Address
Kates, Rodney E/Kathlenn A
R I Box 144 A
Oakland City IN 47660
3286
Rodney E Kates
7329 S 800E State Parcel Number Legal Description
OAKLAND CITY IN 47660-8542
�t��ttr��tt��t tt�tt�tt�t�t tl tl�tt 11111111111,111 tt�� 26-20-16-300-000.839-001 001-00839-00 PT SW 16392.00 AC
Itlrtllttr
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.
I PART 2:TAXPAYER INFORMATION
Owner I First /' Middle Last
&o ye.._ r^,e.(
g Address( and street.city,state,and ZIP code) Efme as property address '
73x9 s, goo coxf 0„0,44 c,trr u) 47460
Spouse First Middle (//�'�'y t Last
AfA ttebI Ail,. r �cCk�S'
Mailing Address(Number and street.city,state,and ZIP code) Mptmlc:u property address
-
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.
Ow I Signature Date
MART 4:ADDITIONAL INFORMATION
CLAIM FOR HOMESTEAD PROPERTY TAX &-"FORM YEAR
CREDIT /STANDARD DEDUCTION
State Focur 5473 W 15-0g
Pmsabed by do DeparUnart of Lo ®I Gavermrsit Fvfanoa
INSTRUCTIONS: See iaverse side for Ong instructions.
I (We) certify that on the 1st ddl 'A
I (ft) occupied as our prir#a! place of residence the Mowing described real pup" for which a Homestead Property I
R
I (Vie) owned El Are buying under contract
Have 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 contraa
tf buyng on contract, Fee Simple omm's name
Pimcordeesollice -am cordradis retarded Pjxwd number Page
i d"'�' y FROPERTYdESPTii
County
County
Township
I Thong 7cify toll'", township)
USE ONLY
Parcel r*ATdw
d deactiptJon
rr 3
Is On property in Mmsbon:
I
Date signed
s&l /j, -
-
❑ Real prop"
❑ M.W. H. (AC. 6-1.1-7)
any portion of the residential structure or the lard not cmeeMV one (1) acre that rnffmcliately surrounds dud structure m used to produce irhmrro. describe the use, and portion
the prop" Wff"d to procluce irxxhme-
W*VM
sunuiunding mmidential mvroveomts.
40-300
-000. 8.39 -00/
Y'k,
d A,!
� N
x-4
'iASSESSOR
County
Township
ZA��n.—
County
USE ONLY
Township
I hereby certify the above staternents are true, correct and complete.
Signature of claimant
A,,AA
Date signed
X
jjk*e�s (nunber and sheet ay: sue, ZIP code)
W 7.3 al S. Vol) clm&t 4.vodmil
Sill Y?66z)
� N
x-4
'iASSESSOR
TA
ASSESSED VALUE
ZA��n.—
W-Sim MAL-4-1,
USE ONLY
$
Valuation or 535,000
'J}WOW
Date signed
Land not exceeding I (one) acre i ffvTwdh&*
W*VM
sunuiunding mmidential mvroveomts.
Y'k,
d A,!
Other land
(2)
iL'
Total land (Ikm I pkis Erne 2)
(3)
Dwelling
cif g
Residential opmvernents or Annually
(4)
Assessed Mobile I Marpr.factured Horne
Garage
gjs
(5)
(Ydw improvernents
(6)
Total rnprovernents (rme 4 ftough fine 6)
(7)
Total value (Ikte 3 plus fine 7)
(8)
1 hereby certify the above is true, ooffeck and
cmViele.
Swmhm of Asiiessor
Date sigrhed
Vaffft action - Sgrature of Auditor
Data signed
- K"A
t"j,'STANDARD DEDUC7KIWALL
20_Pay2O_
Lesser of M Homestead
$
Valuation or 535,000
Surralrffe of Auddor
Date signed