HomeMy WebLinkAboutHomestead_Johnsona�^�3 i CLAIM FOR HOMESTEAD PROPERTY TAX
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INSTRUCTIONS: See reve�se side lor /iling instructions.
FORM AR
HC10
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I(We) __ _��/�l� I ��+.:.V Y�—� - certify ihat on ihe t st d(�� of Ma h,
e upied as our principal place of resident2 ihe following described real property for which a Homeste�ropert Ta CretlA is imed:
1l� „a�s 8
' � n�_ �••:-V G.,.,..0
L, I (We) owned ❑� Are buying under contraci• . . �.�%�%',,, _ � . �
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❑ Have a beneficial interest in ihe entity ihai is liable for the property taxes on the property and that owns he property or is buying under a contract.
� � - � CONTRACTRECORDED '� � � -
If buyi�g on contract, Fee Simple ownefs name :
ReCOrder's oflice where contract is recorded ReCOrd number Page
Counry
r I n iber'
If ariy portion ot the reside
of ihe propeny utilizetl to �
� - PROPERTY DESCflIPTI N - � � '
. Township �� . Ta�ci�g dislri t (cit : to .o -
Legal desCription
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stmcmre or the lantl not exceeding one (1 � aae ihat immediatety surrounds that swcNre is usetl to protluce ir�come, describe ihe use arid portion
ice income. .
PROPERTY OWNED BY CLAIMANT IN OTMER COUNTIES -
Township Couniy
eby certify the above statements are true, correct and complete.
Adtlreu (number antl streeC dry, st e. ZIP code)
� p # � �._, -� ,� � ,
ASSESSOR USE ONLY
Land no� exceeding t(one) acre immediately
surrounding residential improvements.
Other land
Total land (line 7 plus line Z�
Dwelling
Residential improvements
Garage
Oiher improvemen�s
Total improvements (line 4 thiough line �
Total value (line 3 p�s line �
I hereby certify ihe above is irue. correcl, and
wmplete.
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(3)
(4)
(5)
(6)
(�)
le)
TRUE TAX
VALUE
olASSe55or
Gaimant
ASSESSED I HOMESTEAD I NON-RESIDENTIAL
VACUE VALUE VALUE
Date signed
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay19_
Lesser of il2 Homestead
Valuation or 52,000 5
Sgnature of Auditor . Date signetl
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
632
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Individuak and m�:riN couples are limi�cd �o onc homeucaJ �raiMaN �-dunion..4s Ne receipt o1 t:ti> dedunan baome� ,
more beneficial, thrrc is morc incentne than ecer (or humn'teaA frauJ. Ilom vead fnud causes hi�her Ia• bills lor all: thertfae.
HEA 1333-7009 requvn uipaiers who receive ihc haneneaJ standard AeJunion �o veri(y tfut they art� elieiNe io rcccne ihc
benefit anJ to p�w�ide addi�iowl identiiyinc in(urmatiun mxrsvrv io alluw counq� emrmmem �o M;rr mmiror homrnead
fili��. This informatim x�ill be Aryu confidemial and �n nnly fn� etcessel by awhomed counly oRiciils. The Ikpanmem o(
Lucal Gwermn<m FivMe wdl me this inio�muion tu crta[c wuls Jut �rill help cniu�rv officials diminate homesi<aA irauJ.
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Taxpaver Namr Propertc Address
Johnson, Doris L �
R2 t�k,S RD �
1 ^
PrinremnL`747fi70 /
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Dans L Johnson
3101 E 100 N
Princeton IN 47670.8926
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State Parcel Number
2s-� z-o�-aoaoos.ssa-oz�
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Leeal Descri� tp ion
006-03634-00 PT NV/ SE 3 2 10 1.38 AC
C-1 D7
This form MUST be retumed to County Auditor's office. .
Please do NOT send this form back with your tax payment to the county
+�oR�s � L,
; Address (nwnber and sveet, city, smtc. snd ZIP code)
IDI F /�O /V PiE'/�✓c�'% oi✓ , �N
iccuriry Numbcr (lase 5 dicin) Driva's Licensd5ia�e ID Numbcr (lau 5 di�iB)
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Address (Number and svee4 cily, stalc, anJ'LIP coJc)
Stturity Number (lazt 5 digits) � Dnvcr's Liccnsc/Sta[c ID Niunbcr (la;t 5 digits)
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Jo �{,y s o,✓ ;
�Snmc ns propcm addRSs
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Oihcr (pleace spccif in Pan 4 bcbw)
� Sune u pmpeny adJress
Othcr (plcasc s7�ccify in Part 4 bcloa)
urer.
undersiened certifies, under penalty of perjury�, that the abovr and foregoing infortnation is true and correct and that he or she is elieible to
re the homestead standard deduction on this property. Fach undzrsiened al>o understands that, by claiming additional homestead deductions
.�fully, he or she may be liable for back taxes and substantial financial penalties. ;
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