HomeMy WebLinkAboutHomestead_King (4)FORM HC 1� 7979
Rescrihed By Sute BwrO af Tax tommissioners
To & FiIM in Duplicate
CLAIM FOR HOMESTEAU PROPERTY TAX CREDIT FOR YEAR 19 7`�
SEE BACK FOR FILING INSTRUCTIONS
��(We) � �"�'°-°-� �-'��'�-�u-�-�` ����' =z-- certify that on the 1st day of
arch, 19Z% I, ( e) � upied as our principal place of res dence the following described real property for
which a H/omestead Property Tax Credit is hereby being claimed:
I, (We) LJ owned ��(/�O/Qgy
❑ are buying under contract
❑ have a beneficial intere�s/t in the taxpayer
Property Description in �/-��-n-�-�- County ��O`- Township
Taxing District E6i4p-�ewrr, �ownship): ��O'��4--
Parcel Number
If buying Ofl contract: Owners name ��� Hmoie owner�
or legal description shown on tax statement: �.-���
Q�• ,V uJ �/� /S-z -i/ �7�)
Contract recorded in Recorders Office - Record No. Page
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:
by certify the above statement is true, correct and complete.
�.��; ��� �l �i»/
Atltlress
County
Township
�_ ��67d
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 -
True Cash
Value
Land not 9xceeding 1(onP) ��m diat� �
surroundin residential im ro e s (1) � O o
Other Land (2) � 3 7 v
_Total Land •��� 1�' 1979 (3) � g 7°
Residential Improvements �
ing
� AUDIT rage
Total
Other Improvements
To�mprovements - Line (6) plus (7) equals (8)
I,. y certity the above is true. correct. and complete.
Signamre ot Assessor
Approved
(4) % � S S�o
(5) � � 8 0
�s� /sa��
(7) / 7 0
�8� / s 3 q o
- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
/ 70
%
G �6�7�
oaie
Date: � �
�
Gibson County Auditor
101 N Main
PRIN��N�%�� � Indiridua� and marricJ couplc� arc limi�ad io ore hnmuicsJ ,iandaN �4tWnioa A> the rreipi oi �hi� deducuon trconrc�
merc beneficial, thrrc n morc incrnmr ilun e�er for humrsrcad fraud IlomraeaJ f`auJ <auxs higher tax bills im all: thereFue.
� HE.\ 174i-?0(19 requiics mapa�m who reccrve ihc hanesmuJ standard JNunion m.erily �ha� tAcy are cligiMe m mcene ih.
� benefi� ani ro pnr'idr a�Witio�l iJenviyin•, inWrm�uun �xcex'vrv tu allw� counry� gmrmment W N:trr' monitor Iwmesead
filinf,�. fiis inl'nrmatiw x�ill M l.ml con�;dentiai and nn nnl}' Fc arresscJ by autMrienl rnumy n��ial��'I'hr Ik7vnnmm nf
APH1� Ll� ��J Local Go�cmm<m Pfrontt �vill u�c,this.fntama'i'n=u'arcotc rtrols that:v;ll h;lp cou.n' oFnnal. clfmmatc humn�
�la� ,� G
GIBSON COUNTV AU��TOR
1847
__ Jesse Dennis / Mary Frances Kin�
396 S 325 W
PrincetonlN 47670-8470
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- � ��ss� d
c AAdress (numher mid�;6en, ciry, sure, and Zir codc)
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Addnv
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and s�rte4 ciiy, siate. und "LIP coJc)
Stturin• Numbcr (last 5
-
King,
Dennis / Mary Frances
State Parcel Number
26-11-15-100-001.084-027
V
R3 Ro� cI32
Princcion IN q7670
Leeal Descrintion
006-01084-00 PT NW,15 2 11 8.261 AC
D-17
3
;,�
u� propcm'
Qut 5 digiU) �� Otha (plcasc sptcify in Part 4 below�)
rviiamc , /� �
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S
�-s�� � P�a�� �a�
5 digiG) � Othcr (plcssc specify in Part 4 bcbw)
undersiLmed cerrifies, under penalty of perjury, thaz the above and foreeoing information is we and corrzct and that he or she is elieible to
;e the homeslead siandard deduction on this property. Each undersiened al>o undersmnds thal, by claimine additional home�tead deductions
rfully, he or she may be liable for back taxes and subs�antial financixl penalties. . I
I Sien2ture � � ' Deic Tclephonc �
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