HomeMy WebLinkAboutHomestead_SprinkleFOflM HC 10 7979
PreuriEeC By Sute BoarE af Tax Cammiuioners
To & FileC in WDlicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOA YEAR 19�
SEE BACK FOR FILING INSTRUCTIONS
�(We) ���-� � �� ��-O� ��-�--- �certify that on the 1st day of
arch, 197 Y I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed: .
�
I, (We) Q owned
❑ are buying under contract
O have a beneficial interest in the taxpayer
Property Description
Taxing District (�� Town, Township): �
Parcel Number
If buying Ofl contract: Owners name ��� slmo�e ownep
oo�v-o��v 9
��-�-�-/�- Township
or legal description shown on tax statement:
O�•NLJ�%t/'{-�-i/ (�.o�S'zfi�
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 ihe use and portion of the property utilized to produce income
Any other counties in which individual owns or is buying real property: County Township
�her certify the o� e�st t is-tEue„�orrect and complete.
�V. GC
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' ignewre - Sneet Aaare Ciry. State ana 2io Wae
' 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
T�otal Land � � � � �
Residential Improvements Dwelling
��r� 7 `�}9��
Garage
Total
Other Improve�ts � l
7�prove ent� - Line (6) p'I�isp,�p equals (8)
h.._...� certify the above is true. correct. and complete.
SignaWre ol Assessor
True Cash Assessed Homestead
Value Valuation Valuation
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- ACTION BY AUDITOR -
/70
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Date: ��%��z�
STAiE FOR.N 5)569 QUB-10) TItEASURER FOR\t TS-IA
MPROI'ED BY STATE BOARD OF ACCOU`T5,'_009 PRESCRIBED BY 7}tE DEPMTALENi OF IACAL GO\'ER.\��\T FI\A\CE IC61.1 ::-B.1
' / � / / , . ' 1 � , I � , � ' .�:'
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
•duction 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 homcstead
standard deduction to verify that they are eligible to receive the benefit and to provide additiunal identifying
information necessary to allow county government to better monitor homestead filings. Thi:; information
will be kept confidential and cao only be accessed by authorized count}� officials. The Deparcment of Local
Government Finance will use this information to create tools that will help count}� officials eliminatc
homestead fraud.
Tamaver Rame
Kenneth Wa�me Sprinkle
Cample/e and return to:
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57ou58
4��-. �
Prooem Addr�cs
1989 R' S0 SOUTH
PR W CETON RJ 47670
State Parcel Number
26-II-I4-200-001.848-027
S.e_al Descrimi� n:
PT NE 14 2 11 3.45 AC
D-1
i�iioa�ouuauumu�m
GIBSON COUNTY AUDITOR, ]Ol N MAIN PRInCETON LV 47670
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hliadle
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Same as property aamess
sse Ouier (dazsa se�ily in ?an a ee�ow�
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Atiatlle
Same as proDeny aaaress
Sttle
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lazt
Each undersigned certifies, under penalty of perjury, that the above and foregoing intormation is true and wrreU 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 deductio�is unlawFUlly, he or
she may be liable for back taxes and substantial financial penalties.
o� � s��me oa:a
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