HomeMy WebLinkAboutHomestead_Case (3)FURM HC 10 1979 ' 7a & FileO in WDliwtt
PrescriUeO By Sute Board of Ta� Commissioners
CLAIM FOA HOMESTEAD PROPERTY TAX CAEDIT FOA YEAR 19�`L ✓
SEE BACK FOR FILING INSTRUCTIONS �(C�.� 003b Q' p�
Q� (We) �' ���+- �• certify that on the 1st day of
"�fAarch, 19� I, � e) occupied as our principal pl e of residence the following described real property for
which a Homestead Properiy Tax Credit is hereby being claimed:
I, (We) � owned
❑ are buying under contract
❑ have a beneficial int�est in the taxpayer
Property Description i
Taxing District (City, Town, Township): �
Parcel Number
If buying on contract: Owners
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7ownship
or legal description shown on tax statement:
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Contract recorded in Recorders Office - Record N
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:
y the above statement is true, correct and complete
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�� sueet Aaareu
County Township
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Ciry. Stat¢ ana Zip CoC¢
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 Impro�e �s � Dwelling
,! ti t � `-�' �
Garage
Total
Other Improvements
T�' � Improvement Li (6����J�i�' (8)
I�aby certify t�tr �is true. �,r��f8 complete.
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True Cash
Value
(i) 3.260
(2) —�—
(3) _3�lo O
(41 `�O
(e) 5t83p.�-e�
(6) �
(7) — ° —
(g) �° ��
Si9^aWre ol Asseswr //�
V - ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
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Datc
Date: %�' �l- � %
Gibson County Auditor
101 N Main
PRINCETON IN 47670
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2499
iTAR fORM!!'M Iti /�1
1RlASUREF W0.Ni31A
Individuals anJ mattieJ coupk. are limi�ed io one homexeaJ aandaN dYlunion. As �he roceipi oi �his deduc�ion bmomc
more beneficial, thrrc is morc incenmr Ihan e�rr for M1omestead fraW. Homa'rcael fmuJ nuxs highrr Iac 6ills (or all: thercfue.
HEA I3i4-?IX19 requirts uapa.m who reccice the hanesteaJ s�andard JeAuction �o .erify �Mt they ye clitiNe io reaei�e the
benefit an1 to p`m�ide aiktitional iJrntii��inc infurm�twn necrs'vrv m allw' counn• gm�rmmrm tu beuer muniror Iwmesead
filin�. This in(omutinn will br I.ryM ctmfiAcmial mA can nnlr tt: acm: uvl by awhorienl rounty olTmials.'ITe Ikpanntcnl o(
local Gwrmmem Fim�we ��ili ux �his inimmation m trcatt ewis Jut will h:lp �amq• o(ficiaLa climinuc MmmsteaJ fraud.
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Taspaver Name Prnpem• Address
Case, Mary H
Mary H Case
526 W State St
— — - �PRINCETON-IN�4767Q1345 - ----- -
I�I��II���I�II��I���III������II��II��I��I�II����I�I�II���I��II
5?6 N' Smte ST
1'rinccton IN 47670
State Parcel Number Leeal Description
X 26-12-07-103-000.380.028 01s-oo3so-oo DEVINS ENLG 4 PT
xner I First MSd<
/UT A � y �/.
�g nddru.i lnamh.x miJ >4at, ciry,�s•s:e, and Z:P ^c�E/: -
�S�(� W. ��2-�e- �f. /"��.UcEfi�N��" 7!�%
xial Securi�}' Numba (last 5 digits) Urivers License/Sute IU Number Qasl 5 digils) O�h<r (plc
- - �_ ..:a.
Address (Number and strtt4 eiiy, s�ate, and LIP caie)
bcr (lan 5 digics) Drivcrs LiccnsdStace ID Numbcr (1ut 5 digits)
�'AS�
�rorem edd�cs, _
� Samc as pmpcny adMs;
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undersibmed certifies, under penalty of pepury, that the above and foregoing information is we and correct and that he or she is elieible to
�e the homestead standard deduc�ion on this propeey. Each undersigned al>o understands that, by claiming additional homestead deductions
�fully, he or she may be liable for back taxes and substantial financial penalties.
1 Signatiut Da�c 7'cicphone
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