HomeMy WebLinkAboutHomestead_Collins (15)FONM HC tU 7979 io & FiIW in Duplicate
HescriOeG By State BoarG ol Ta� tammissianers
CLAIM FOR HOMESTEAO PROPERTY TAX CREDIT FOR YEAR 19�2 ✓
SEE BACK FOR FILING INSTRUCTIONS 0�:�'_ooy37'�fl
i(We) �`�ij �' S/��"{�d �-�.� certify that on the 1st day of
March, 19�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) C�'owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer �n
Property Description in ���i-d_t+^-� . nCounty `�'a�s-,G�-- Township
Taxing District (City, Town, Township): `�/�-�w u�n�.�L-O
_ Parcel Number or legal description shown on tax statement:
`%i��4s-�9c/lo 6
� i
If, buying Ofl contract: Owners name ��� simo�e owner�
Contract recorded in Recorders Office - Record
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 . ship
. ��J —�a—
,`�tiereby certify the above statement is true, correct and complete.
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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(one) acre immediately
surrounding residential improvements
Other Land
Total Land p � (�
Residential Improvement 8 � [�����
�L+relling
iUN 4 7 �g79 Garage
� Total
Other Improvements �
��, �
i��nprovements - Line p s �
I i,..,coy certify the abov is true. cor�Qland complete.
Asseswr
True Cash
Value
(�) �i.Zo
Assessed
Val�0
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- ACTION BY AUDITOR -
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Da�e
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Homestead
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Date: � - z �- %J
Gibson County Auditor
101 N Main
���T N IN�O�
APR 7 2010
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— BIHB@N C6UNiV AUBIiOH
1407
DARVIN L COLLINS
C/O BILLY COLLINS
2013 BLVD PL
PRINCETON IN 47670-3445
nrwsuuxwav:s.�n
InJieiJuaL. •r"
and ma� iN <oupl� are limi�ed to orre homcacad AanAaN Jtdu.�ion. As ihr �ttrip� ol �hi> dodunion 6icmie_
more brneficial, therc is morc imrntnx than r�er for homnie:d frauJ. Ilomesrr�l fiaud causes h'n_her u� bills for ali; Ihrreftte.
HEA 1i17-?009 reqvires uaparcrs �'ho rceivc ihc hanes�cad ..undard dNuciion �o verily tMt ihcy are eli;ible io maeirc ihe
brnefit anl tu p�a'ide aJdfGonil identiipfn_ infiumatiun �cr.sarr b allw' cou�n� gm'emmrn� m b:ner mwiitw humeste:xl
tilin�. Ihis infamu�ion xill br kcry emlideniial anJ can nnly Ix azacsscd M awhmimd rnunry� nfficivls. Thc Ikpannmm of
Lucal Gmammcm FitiMC �vill ua this inio�mation W crea�c twls ihat �rill hclp counev offiriaL+ eliminnie Irom<s�cml fraud.
. • ' , , ' .
���u��in�i��ii�in����ini��ii�ii�i�n���i�nu���i��ii��ii�
T•rxpa��er Neme
Collins, Billy M
State Parcel NumDer
,Y 26-12-18300-000.437-028
Propem� Address
zoia �;i.avi
I'rinnron f\ a7670
Leeal Description
01&00437-00 BROADLEIGH PARK
94/95l96
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Owner I First Middle Lasl
�/�/ /� � e % / /.v S
e Address pmmber end>riee[, city. ae�c, anti ZIP eodcl — - ' - --� -" - - -' Snme s� pmpenywidny - � - -. . . - -- -
�
$ocol $ecuriry' Number (laa i dicits) Dricer's License/Slate ID Nmnber (lazl 5 digiu) Oeher (please specify in Pan 4 belaw)
�� �
Spoiuc First Middle Lact
Mailin�; .4ddress (Number and suee4 ciq�, s�ale, nnd ZII' cude) � S;une u pmpem addrta;
Social Securiry Number (latt 5 digits) Drivers Limrtu/S�atc ID Ninnber (las� 5 dieies) O�hcr (please spccif� in Pan 1 below�)
so�
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Each undersiened certifies, under penalty of perjury, that the above and foregoing infonnation is we and coirzct and t}mt he or she is elieible to
receive the homestead standard deduction on this property. Each undersi¢ned also understands �hat, by claiming additional homestead deductions
unlawfully, he or she may be liable for back taees and subsiantial financial penal[ies.
Ounn I Si�maimc Untc Tcicphurc
- � ��Q,� �-T- �� � - � � � �
Spou;e Signa[u:e py�c Tclephonc
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