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Homestead_Miller (4) MATE.FORM.rw nC 1,N1 MRFASU[MM FORM TSIA I Ar/RCAEO B\SIATL WARD Or ACCOUNTS-!n.0 PRIStIE[D BY nn oEPARTM:NT OF LOCAL ctOV?tN•FA'T FBPAA'cFlc r.t-.I Gibson N Main Nn County Auditor 1 IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 7. 10 PRINCETON IN•47670 Individuals and married couples are limited to one homestead saandanl deduction.As the receipt of this deduction becomes more beneficial.there is more incentive than e'er 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 recent the benefit and to provide additional identifying infomammn recessrr•to allow county government to better monitor homestead tiling..This information will he kept confidential and on 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 I: PROPERTY INFORMATION Taxpayer Name Property Address 'I Miller, Steven E/Nancy G R 3 Box ox 1 10 �y !� • Oakland City IN 47660 8578 Steven E/Nancy G Miller - 5863 5-1 02 5E - — -- - -- - - ---State Parcel Number - - LeoalDiscription" --�"- ---- Oakland City IN 47660-7712 26-20-11-200-000.541-001 001-00541-00 PT NE II-391.851 AC Il�ttlltttltllt ttilttllttt ltrtlitrtlrttlIt titltlltrttIltrttlli PART 2: TAXPAYER INFORMATION Owner I ,�/ First Middle Last ,/V 4ncy Tar] 0//E` �g Address(number end street,city,state,and ZIP code)) City 0 Same as property address — - —- - -— Y313 -5 /Ud 5 P Oa �nJ Ciy I- N /7 (TO Spouse First Middle Last Mailing Address(Number and street.oily,state,and ZIP cock) 0 Same as property address Social Security Number(last 5 digits) Drivels Licensc/State ID Number (last 5 digits) Other(please specify in Part 4 below) • slaw 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 hack taxes and substantial financial penalties. Owner I Signature Date PART 4:ADDITIONAL INFORMATION • I FORM HC 10 1979 To Be Filed in Duplicate Prescribed By State Board of Tax Commissioners CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 192 principal place of rq9ence the following described real property for which a Homestead Property Tax Credit is hereby being claimed: I, (We) ❑ owned C?6-0�0 ❑ are buying under contract ❑ have a beneficial intelr/gst in the taxpayer Property Description in �� • •- County 'A Township Taxing District (GAy-Tewm, Township): Parcel Number or legal description shown on tax statement: �/..r/cy / / -a -9 /.��-/ If buying on contract: Owners Contract recorded in Recorders Office - Record 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 Any other counties in which individual owns or is buying real property: County Township hereby certify the above statement is true, correct and complete. Street Address Cdy. State Individual either owns or is buying under a contract that provides he is to pay the property taxes on the residence, or has a beneficial interest in the taxpayer. Residential Improvements Iing a� e AUDITPRal Other Improvements provements - Line (6) plus (7) equals (8) certify the above is true, correct. and complete. or Assessor (a) / 3 / / o (5) (6) / / 10 (7) ) O /00 (s) / </ / 7 0 PRA Assessed Homestead Valuation Valuation 170 /Vo V ACTION BY AUDITOR - Approved: ,01• `Y Date: S" / - FOR ASSESSOR'S USE ONLY - True Cash Value Land not exceeding 1 (oncrimm diatet surrounding residential im ove nts (1) 3 0 0 Other Land (2) yo Total Land =iii'' 5 1979 (3) 93o Residential Improvements Iing a� e AUDITPRal Other Improvements provements - Line (6) plus (7) equals (8) certify the above is true, correct. and complete. or Assessor (a) / 3 / / o (5) (6) / / 10 (7) ) O /00 (s) / </ / 7 0 PRA Assessed Homestead Valuation Valuation 170 /Vo V ACTION BY AUDITOR - Approved: ,01• `Y Date: S" /