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STATE FORM!Jr.* fWit TREASURER FORM 7-tA
.AP/ROVED PT SLATE BOARD Of NrCENTS.1.v FRIARtnm BY Tilt DEPARTMENT OF LOCAL Cill‘C'P_NMFAT FINANCE IC 11-I.I-2_J.1
0 County Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
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 Homestead fraud causes higher tax bills for all:therefore.
• HEA 134-4-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recebe the
benefit and to provide additional identifying information necessary to allow county coemment to better monitor homestead
filings.This information will he kept confidential and ran only he accessed by authorized county officials.The Department of
Local Govcmment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Whitaker, Patricia A
P O Hox 232
tilberfeld IN 47613
972
Patricia A Whitaker
PO Box 232 State Parcel Number Legal Description
ELBERFELD IN 47613-0232
Itlnlltultll liu lltiluuFitlnlIntltlnlln tltilnrll 26-20-32-100-001.139-001 001-01139-00 PT NW 32-3-98.50 AC
D-10
PART 2:TAXPAYER-INFORMATION
Owner I First A. Last
I"a-FftC\a A. w4--c.-4-0.we,
111111g-Address(number aid street,city,state,and ZIP code)— "-- ''O Same as property address -- --- - - — —
P 0. Box a 31 1 0055 5*u*e. Pocket 57
Spouse First Middle Last
DtCGoSe4
Mailing Address(Number and sweet,city.state,and ZIP code) 0 Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
SOW
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-additionalhomestead deductions - -
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date
•