HomeMy WebLinkAboutHomestead_Hill (3)FOflM HC 10 19i9
HeSUiDeO By Slate Baa�a of ia+ Commissioners
7a Be Filea in Wplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 � y
G INSTRUCTIONS
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(We) i certify that on the 1st day of
arch, 19 �' I, (We) occupied as our pri ipal place of residence the following described real property for
- which a Homestead Property Tax Credit is hereby being claimed:
I. (We)�,owned OD�-���D
❑ are buying under contract
❑ have a beneficial intpeArest in the taxpayer
Property Description in �lJ-�-a-o-�� County �� Township
Taxing District (Ck-y-�ewrr,'i'ownship): ���-
Parcel Number or legal description shown on tax statement:
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If buying on contract: Owners name '!eP
Contract recorded in Recorders Office - Record
Ii 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:
�hereby ceriify the above statement is true, correct and complete.
'Signawre
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Stteet ACOress
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County
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Township
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ane Zip CoCe
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.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immediately
surrounding residential improvements
Other Land
Total Land
Residential Improvement� �
Other Improvements
T� Improvements - Lin
I eby ceriify the abo s•
`
Sgwmre o� nsseswr
Approved: � ' '
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$'�'a� �
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JUfd ? � 397g Tota�
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True Cash
Value
(t) //S o
Assessed Homestead
Valuation Valuation
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- ACTION BY AUDITOR -
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Date: � — ` � ` � y
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Gibson Caunty Auditor
101 N Main ' � ' � � � I • • � • � •
PRINCETON IN 47670 InJividuaL anJ ma:rieJ couple are IimitN io onc homcueaJ ya`MaN JNu.�ion. As the rttript o1 this dcdunion bccm�e±
� mure beneficfai, thrre i. morr inrrn;n'e than rcer (or homesrcad fnud Ilomnxad fiaW causa higher ta� hilk for all: thertfae.
� HEA 13A�-?009 requires �a�payrn x�ho reccivc ihc fwmcsieaJ smndarJ deJunion �o veri(y tlwi thcy are cli¢iNe to rcccnc ihc
��� .e pruriJr akliiio�ul iJemiiyinc in(wmmian �cesnry to alluu' counn� gv.�rmmrnt to Y.nei muniror honxsttaJ
� nf.�. liis umvunn will be 4.� conlidcnlial and nn nNy h. atre�ml Fy autMriud munh� olTiaial:. Thr Ucpannrcnl o(
I. I mr . m Pinam�c will um �his inionnation cu crca:r nvls Ihm w'ill hclp rqmt�� ulTcial> dfm�raic Fpmcstcad haud.
— APR 1 9 �uw
OIB60N,0 UN� AUOi7pR
3421
Wilma G Hill
41 S 180 E
Princeton IN 47670.8961
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nnd svicel, ciiy, smte, and ZI P code) �
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an 5 die�u) Ddver'S LittnSe/Su�e ID
Addrtsti (Number anJ stree4 ciiy, siate, und "LIP cak)
Stturirv Numbcr (lazt 5 digics) � Drivds Liccnsc/Stacc ID Nianbcr (las� 5
Tazoacer Namr
Hill, Wilma G
Stare Parcel NumAer Leeal Descrirition
26-12-09-302-000.86&027 ��-�868-0o PT SW 9 210 .92 AC
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� $;une � piapeny addrrss
undersiened certifies, under penalry of pequp�, that the above and foregoing infoRnation is we and correct and that he or stie is elieible to
e the homestead siandard deduction on ihis propert}•. Each undersicnzd also understands tha�, by elaimine additional homenead deductions
fully, he or she may be liable for 6ack tases and subs�antial financial penalties. �
I Sirnatmc Umc Tdephonc �
Sipiatvre
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Tcicphonc
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