HomeMy WebLinkAboutHomestead_Akers STATE FORM!)'M IR r 5-N) TkL'StIIER FORM PS IA
APPROVED BY atITE&WOOFSCTLYT[.!vu PRESCRIBED BY RR DEPARTMENT OF EIXAE roSYRNMEta FINSNCEMVt.1-r-Li
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sandard deduction.As the receipt of this dedtraion becomes
• , more beneficial.there is more incentive than mer causes homestead fraud.Homestead fraud caes higher tat bills for all:therefore.
t 1 HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
®� f benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
fl filings.This information will be kept confidential and can only hr accessed by:uthorned county officials.The Department of
Local Government Finance will use this information to create roofs that will help county officials eliminate homestead fraud.
APR 1 2 2010 PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Akers, Anna Mae
GIBSON COUNTY AUDITOR 423 u'Oak ST
Princeton IN 47670
722
Anna Mae Akers
423 W Oak St State Parcel Number Leal Description
Princeton IN 47670-1236
11111111111111111111111 111111111111111111111111111111111 7( 26-12-07-101-000.020-028 010-00020-00 CUSHMAN ADD 25 PT
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
/
In /�C ////,,
�tg Address(number and street.city,state,and ZIP code) Same as property address
4,z.3 alt'- t" C9J at /% 4tc � .J,. 16 9
Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as propery address
Social Security Number(last 5 digits) Driver's License/Statc ID Number (last 5 digits) Other(please sps.cify in Pan 4 below)
St=
PART 3: CERTIFICATION _--- - — ' — -- --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
FOPM HC f0 1979
PreSttiheE By State BwrE af Tax Commissioners
To & Filed in Dupliwte
CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOR YEAR 19 ` �
SEE BACK FOR FILING INSTRUCTIONS a9 � OO�a.O' �
`(We) U-�� certify that on the 1st day of
��iarch, 19�, I, ( e) occupied as our principal place of residence e iollowing described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial inter st in the taxpayer
Property Description in �� � �
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name �'� "^'o'e °^^ef�
Township
or legal description shown on tax statement:
l !. .(I � iv,-, �e �,.� �J (�L_ii� � S �
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.
.
naaress
County Township
7J
Sute anE 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 -
Land not exceeding 1(one) acre immediately
surrounding residential improvements
Other Land
Total Land � I L � �
Residential Improvements Dwelling
. i i 1 1 (�l�e
� T/�Other Improvements �
T�'-' !mprovements - Line (6) plus ) equals (��DITOR
I'�ry certify the above is true. c�}rect. and completq.
Sig(Idtu�¢ O� ASSPSSO�
True Cash
Value
( � ) .�O`t�
(2) —� �
(3) �
(4) �
cs) / 3—��O
cs> �
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Assessed
Valuation
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Homestead
Valuation
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Date: �'�9 ��