Homestead_LinxwilerFORM HC 10 1979
PreuriEeG By State BoarC of Taa Commissioners
CLAIM FOR HOMESTEAD PHOPEATY TAX CREUIT FOR YEAR 19�
To & FiIM in OuO����e
� SEE BACK FOR FILING INSTRUCTIONS
�(We) �+-�--�-� ���r���--����e�-^-n- � certify that on the 1st day of
arch, 19 '79 I, (We) occupied as our principal place of residence the tollowing described real property for
which a Homestead -Property Tax Credit is hereby being claimed:
�; (We) � owned
❑ are buying under contract
❑ have a beneficial inter�st in the taxpayer
Property Description i
Taxing District (GiEy;—�ewn, Township):
Parcel Number
If buying on contract: Owners
��e.�
00�-OIIR3
"� Township
or legal description shown on tax statement:
��_ ,vc'�� ��-Z-,o ��6A�
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:
�hereby certify the above statement is true, correct and complete.
� D�,,.�..�_ �'�,G,�P�-� �,P�z. �
County Township
ana Zip CoGe
� �C 7�
' 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 Improvements � Dwelling
JUi�I �.1 i979
Garage
�� /�/�otal
Other Improvements AUDITOR
TN Improvements - Line (6) plus (7) equals (8)
I�by certify the above is true. correct. and complete.
Sigeumre ol Asseswe �� U
True Cash
Value
(�) 5 8 0
(2) '_
(3) �s °
(a) �v �/o
cs� �
(s) G � i b
(�l 7-�--d
(8) 7 3.0
Assessed
Valuation
-�`� �70
�
,_ ,
�-7—�9
Date
Date: _--_-1 � /
Homestead
Valuation
�� / 70
� ,.��.
STATE FORM 53569 (R318-10)
APPROVFD BY SfATE BOARD OF ACCOU�TS, 2009
� � TAEASIIRER F00.M TS-IA
PRESCRIBFD BY THE DEPARTh(E\T OF LOCAL GOVFR.\)f[.\T Fl�A��CE ICbl.l :'_-e.l
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
�duction becomes more beneficial, there is more iucentive than ever for homestead fraud. Homestead fraud
causes hig6er tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
standard deduction to verify that they are eligible to receive the benefit and to pro��ide additional identifying
information necessary to allow county government to better monitor homestead filings. This�information
will be kept confdential aod can only be accessed by authorized county officials. The Department of Local
Government Fioance will use this information to create tools that will help couuty official� eliminatc
homestead fraud. � //
T�:oarer \ame
Elnora F Linxwiler
Comp(ere and �etun� to:
o�. �
� (NQ
�302
�
$oWSe
Prooertv Addrns
2302 E SR 64
PRINCEfON IN 47670
S�ate ParcA \vmber Le¢�I Dcstriotion:
�
26-12-16-200-001.193-027 PTNE 1621ti .46AC
IYU'+1911� Wf 4OY�YY W�YI
GIBSON COUNTY AUDITOR, ]01 N MAIN PRINCETON IN 37670
Fval
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eet, aty. stata ard ZIP cotla)
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+
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Same es pevperty �esa
sue � O'J�x (dease spauly in Pan 6 Eelrnv)
- . . Lasi
Each undersigned certifies, under penalty of perjury, that the above and foregoing information is true and wrred and that he or she is eligible to receive the
homestead standard dedudion on this property. Each undersigned also understands that, by claiming additional homestead deductions unlawFUlly, he or
she may be Iiabie for back taxes and substantial financial penalties. �
Owrer 1 Sipnature Date Teleptone
�� II^ z- 12 ( �/
SW�+se S��va �ala Teieyme
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couNrv