Homestead_Rothrock (3)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDMSTANDARD DEDUCTION
Sbft Form 54r3 (R715-061
Presorted by the Departmard of Lociii Government Finance
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 contract.
-CONMCTAECOFWED,'��l`
If buying an ..tract Fee Sirriple owners neme
Fitz,corder's allies where contract is recorded R000rd number Page
- 'PROPERTY OWNED WeLAntAw d OTHER CCnH4FM;,
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PROPEIZIN I)FSCPJP110N
Counly
Township
County
ThoN district (city, tonvn, fowmfw)
I hereby certify the above statements are true, correct and conViele-
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tlesoription
dEkkeiq (number &W sh afy, stets. IlP Dods)
.W V 1111�7xs-
Is the property in question:
1co -00.
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❑ Peal property ❑ MoWl. Fla. (I.C. 6-1. 1-7)
Harty portion of the residerntial s6umaa n the land net exmeGrg ono (1) ace that inrte6aley sumounds that sblm;bxe 13 used to produce ino:iriie, desoribe the use and podim
Of ul; property Wiraid 11D produce inairiiii. P�LJ
1JLJ t-3-4j Li-A.
- 'PROPERTY OWNED WeLAntAw d OTHER CCnH4FM;,
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County
T-- nship
County
Township
I hereby certify the above statements are true, correct and conViele-
AT
'
Yl
dEkkeiq (number &W sh afy, stets. IlP Dods)
.W V 1111�7xs-
-TRUETAX ti
ASSESSED W1ti
A'IljjbjE TEAR
NOMMSUNK
% ASSESSOR ustowy
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Land not exceeding I (one) aiona immediately
surrounding residential improvements.
OHM tam
(2)
Tdal land (fine I phus fine 2)
(3)
9
Residential improvements orAnnually
Dwelling
(4)
K
Garage
(5)
F V N
Assessed Mobile Wanufactizied Home
Other improvements
(6)
lie
Tdal irnpruvements (finia 4 through fine 6)
(7)
Total value (Inie 3 ph& fine 7)
(8)
1 hereby cartify the above is true, correct, and
Signature of Assessor
Data silted
complete.
Vardying action - Signature of Auclitor
Date signed
20—Pay 20
Lesser of 112 Homestead
Valuation or SM.000
Signatiffe of Auditor
Date signed
STATE FIRM DS.IR!W+1 TREASURER PORN:B-IA
• APPROVED
IMPORTANT NOTICETO HOMESTEAD tP PROPERTY OWNERS '
Gibson County Auditor
101 N Main
PRINCETON IN 47670 Individuals and married couple arc limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than eser for homestead fraud.Homestead 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 receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
tiling>.This information will he kept confidential and can only be accessed by authorized county officials.The nmanment of
Local Government Finance will use this information to create tools that will hip county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Jamie Rothrock
R I Box 163 D
Oakland City IN 47660
3188
10715E 450 S State Parcel Number Lesal Description
OAKLAND CITY IN 47660-7672
II II III II it I III I I it 111111 I 26-20-01-100-001.912-001 001-01912-00 PTW NW 1-3-94.00 AC
ru ntt ut n ut net nnrutut terra D-8
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.
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Spouse First Middle 'oar ix/ej ' S �'o �Crcc.�
Mailing Address(Number and street,city,state,and ZIP code) I I�r Sane as property address
/D 2,c �G. �(Sb S. C�ke1ana'
6-3 v2eat 6 0
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.