Homestead_BlakeSi.�TE FOR.\1 i3>69 (R31&10)
.�PPRO\'ED H\' STAiE BO.VtD OF ACCOU�TS, 2009
TRF.�SURER FOR,�I TS-IA
PRFSCRIBED Bl' THE DFPAATtE�T OF LOC,LL CAl'ER.\TfE.\T FINARCE IC61.13'_-8.1
� O s . O G. �. D � s O� � O e �
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
deduction becomes more beneficial, there is morc incentive than e��er for homestead Traud. Homestcad fraud
�auses higher tax bills for all; therefore, HEA 13�1d-2009 reyuires taxpayers �vho recei�•e the homestcad
standard deduction to verif}� that the�� are eligible to receive the benefit and to provide additional identifying
information necessan• to allow counh� government to better monitor homestead filings. This inTormation
���ill be kept confidential and can only be accessed b�� authorized county officials. The Department of Locu�
Go��ernment Finance will use this information to create tools thut «�ill help count�� officials eliminate
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Each undersigned certifies, under penalty of perjury, that the above and foregoing infortnation is We and correct antl ihat he or she is ellgible to recerve �
homestead standard deduction on this property. Each undersigned also understands that, by claiming additional homestead deductions unlavrfully, he or
she may be liable for back taxes and substaniial financial penalties.
O.vner 1 Sigriature
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DEC 2 7 2012
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