HomeMy WebLinkAboutHomestead_Chavis (4)�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
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Each undersiened certifies, under penalty of perjury�, that the abo�•e and foregoing infunnation is We and colrect and th•rt he or she is elieible to
receive the homes�ead siandard deduction on this propeny. Bach undersigned al>o understands that, by claiming additional homestead deductions
unlawfi�lly, he or she may bz liable for back taxes and substantial financial penalties.
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FOflM HL 10 1979
Preuri�eE By Sinre Boxrd o� ia. Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19
to Be FileO in Wplicate
✓
SEE BACK FOR FILING INSTRUCTIONS Q�9- 0039g- OD
�(We) -^ � R-O �� � *P^ �S—, ���` —� �- certify that on the 1st day of
March, 19 I, (We) occupied as.our principal ptace owresidence 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 interest in the taxpayer
Property Description
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name �'� 5inip1e °"ne`�
nty ' � �'�-�a-�-% Township
or legal description shown on tax statement:
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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: County Township
�hereby certify the above statement is true, correct and complete.
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acreei rooress
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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 (on����l�
surrounding residential imp e n
Other Land
Total Land
Residential Improvements�
;;,P,� 4 i983
elling
� pUDiTOR Garage
Total
Other Improvements
i�lmprovements - Line (6) plus (7) equals (8)
I by certify the above is true. correct. and compiete.
Signa:ure oi Assessor
True Cash Assessed Homestead
Value Valuation Valuation
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- ACTION BY AUDITOR -
Approved: Date:
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