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Homestead_Riley {lAt£rotsI !r.a IC/YA1 TREASL[EA PORN Z!A • APPROVED BY STATE BOiRDOL MrTLNfl.911. PLESCIfBED BY 111r DEPARTMENT OF 1.00.1.COVELYM!TT FINANCE wsI.I-:_-!.1 Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS Main , PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore. • HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recche the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filing_This information will be kept cent:dential and can only he accessed by authorized county officials.The Department of Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Riley, Allen J/Sandra L R2 \LA FRANCISCO IN 47649 1828 Allen J Riley 8084E 300 S State Parcel Number • Legal Description OAKLAND CITY IN 47660-8511 I'uI I n I I nI I I I I n 'l l I I u I I'uI 26-13-28-200-001.432-004 002-01432-00 PT NE 28 2 99.241 AC 1 n nr t r t ei ie t im t ei ei r C-1 D-6 This form MUST be returned to County Auditor's office. Please do NOT send this form back with your tax payment to the county treasurer. PART 2:TAXPAYER INFORMATION Owner I First Middle Last nllem Ube. d g Address(number and street.city,state,and ZIP code) ©'Some as property address Spouse First Middle Last Sdra. Lua//el. R Mailing Address(Number and street,city,state,and ZIP code) Warne as properly address . Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is eligible to receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions unlawfully,he or she may be liable for back taxes and substantial financial penalties. Owner I Signature Date • FORM HC 10 1979 To Be Filed in Duplicate Prescribed By State Board of tax Commissioners CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 g2- %; SEE BACK , FOR FILING INSTRUCTIONS ��Q ` p9 (We) -�7 `�'� �— mob, � 6Q'^-�'-'�— � certify that opnVthhe� day of arch, 19 v I, (W occupied as our iVincipai place of residence the following described real property for which a Homestead Property Tax Credit is hereby being claimed: I, (We) ❑ owned a — I °S Z S • ZOc no .w 3,;Z -m' f ❑ are buying under contract ❑ have a beneficial inter t In the taxpayer Property Description in County _ a 1z�� Township Taxing District (City _own, Township): Parcel Number If buying on contract: Owners name "" simple owner) or leg aV al description shown on tax tee Contract recorded in Recorders Office - Record 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: County Township hereby certify the above statemen is true, correct and complete. 0 A. -�� -Signature _ City, Slate and Zip Done may,. v ns or is buying under a contract that provides he is to pay the property taxes S�Tesidence, or has a beneficial interest in the taxpayer. nom_ FOR ASSESSOR'S USE ONLY - Land not exceeding 1 (one) acre immediately surrounding residential improvements Other Land Total Land Residential Improvements Dwelling Garage Total Other Improvements - Tor^' Improvements - Line (6) plus (7) equals (8) I06y certify the above is true. correct. and complete. Signaure of Assessor (1) (2) (3) (4) (5) True Cash Assessed Value Valuation (6) l,7-- (8)o o73p - ACTION BY AUDITOR - J�j� mp. yam-. 7G'" - Date Date: Homestead Valuation 8 z 70