HomeMy WebLinkAboutHomestead_Brokaw r MASStr*M I!W,R r4YI •REWitIR raAV TS-IA
.rrWNEn B YSLVL OnARneE■ma\TR].r PRESCRIBED BY TM:DElA THEV O*IGAIGONTILYM04 FINACCEMH.I$il
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple are limited o etc homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than eser for homestead fraud.Homestead fraud causes higher tax hills for all:therefore.
® HEA 1344-200C requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recche the
benefit and to provide additional identifying informmon necesan.ro allow county government to better monitor homestead
Min .'Ibis information will be kept coat;dentin!and can only hr aecenred by authorized county officials_The Department of
ducal Government Finance will taw this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Brokaw, Martha Helen
330 S Prince ST
Princeton IN 47670
2982
Martha Helen Brokaw
330 S Prince ST State Parcel Number Legal Description
Princeton IN 47670-2118
II� X 26-12-07-401-000.253-028 01400253-OO PT SE 7210 .29 AC
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PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
7 Z4) We' -
iAddras(number and st^t.city,state,and ZIP code)__ __ - _. _____.—® Same as property.address
- 330 f 7`'L_- fly , /N /17670 ,012
-- Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same us property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
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 1 Signature Date
•
FORM HL 10 1979
P�esuiGeC By Sta�e Boa�E at Ta. Cammissianers
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR
FILING INSTRUCTIONS
io Be FiIW in Duplicate
,s� ooas3 �
�l9 - . o�
�(We) �� ��/� certify that on the 1st day of
vlarch, 19 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) �.owned
❑ are buying under contract
❑ have a beneficial int�rest in the
,
Property Description
Taxing District (City, Town, Township): �
Parcel Number
If buying on contract: Owners name ��� simole ow�en
� .-a-J Township
or legal description shown on tax statement:
�G.� .� � % 7-a-io . a 9a.�
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.
cT �
SUee� Aaaress
County
—�
Gry. S:ate
Township
Cooe
Individual either owns or is buying under a contract that provides he is to pay ihe 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
ootal Land � � � � �
Residential Improvemenis � Dwelling
�!UN 71979_
Other Improvement � ���~��
^ � pUDIT9 R
T Improvements Line (6) plus (/) eqi
'�by certify the above is true. corr�t
l'
$iJ�IdN�¢ OI ASSPSSOf
Garage
Total
Is (8)
and c^omplete.
""'� v �
_ nrTinni
True Cash Assessed Homestead
Value Valuation Valuation
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