HomeMy WebLinkAboutHomestead_Collins (13)FORM HC 10 19i9 To 8e Fileil in Duplicate
PrescriUeO By State BoarG ol ia. Commissi0ne�s
CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOR YEAR 19_7_`L . ,i
SEE BACK FOR FILING INSTRUCTIONS o/9- o�yy3' 09
�(We) �"�°� `�"' �-a-�^- ��-�`-1�_.�� certify that on the 1st day of
nAarch, 19 7 I, (We) occupied as our principal place of esidence 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 interesj ,in the taxpayer
Property Description
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name ��� simo�e o,,,�e,�
nty �� Township
or legal description shown on tax sta[ement:
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Contract recorded in Recorders Office - Record No
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 tify the a e statement is true, correct a d mplete.
'���;�+coa..�e�dar sP.(�..� 33 ����l�xcss^ �� c��i/a.�4 (�
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gn re Sireet AECress Crty. State an0 Zip Cpae
' Individual either owns or is buying under a contract that provides he is to pay the properiy taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
True Cash Assessed
Value Valuation
Land not exceeding 1(one) acre immediately
surrounding residentiai improvements (�) /%�o �l00
Other Land � � � � �
Total Land
Residentiai Improvements Dwelling
' _�U� 22 �9�9 Garage
�� /�(�` —�iL—Total
Other Improvements Q�p�
AUDITOR
Tr•,� Improvements -. Line (6) plus p) equals (8)
I�•by certify lhe above is true. correct�and complete.
Sigewmre o� nssessor
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Homestead
Valuation
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Date: ��/_7__�Z_—
' Gibson County Auditor
101 N Main
PRINCETON IN 47670
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rnrnsulu mau n-�n
InJiriJuaL. anJ ma;riN coupl� are limi�cd io nrc Irome�eaJ yandaN Jniunion. Ar �he rmtipt of �his dcdunan bttrnrc_
more beneficial. �herc is morr incenmx tlun aer (or homestead fnud. Ilomnttad taml causes hi�her iac bflls Im all: tlxrtiae.
HEA 13�1-F-3009 requim ucpa.en v.�ho racei.e ihe hanestead s�andard dNuction in rrrily ihat they are elieiNe io meei�e the
benefi� aN to pmviJe :ulJiiional iJentiiyfnc inWrm:niun nmavrc ro aliw' counn� gucernment �o berter moniror hume�te:xl
lilingc. Iliis inlumulinn will be kc�v tmlidemial anA ran nnk he acrrcuA F� authnriieJ rnmuy n(Lciuls.'fhr Ury�anmem of
Lucal Govemmem Pinam'e will m< �hi_� inionnation W crcate [wL. Ilui aill hclp �ronnrv ufficials elimmarc Iwmesrcad Baud.
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Taxparer Name Prnpertc Addresti
Collins, James Gordon/Betly L Trust
James Gordon / Betty L Coliins
334 S Seminary ST
Princeton IN 47670-2122
�i�n��in�i��n�in���i�u����n���n�i�u�i�u��u�n�u����
333 S Scminarv ST
(Rinceton IN i7670
Stare Parcel NumAer LeQal Descrip�ion
�{ 26-12-07-401-000.443-028 01&00443-00 PT SE 7-2-10 .18 AC
1 1
Ox'ner 1 First Middle . Last
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" dLrtv (rmbc -w.d svat :i::. �mtc, a�d ZIP ca:) �� Sumc as pmMrty edd.c::
3,J� � � , � 2 n/� / N /� �' s �. ��Y� � ��vi c e�-a �J �%A/- �}� �' � °
$ociql $ctvrity Yumbe� (last 5 digiLS) Ihiver's Licemc/Su¢ ID Nmnbcr Qazi 5 di�ils) Oth<r (ple�se specify in art 4 bciow)
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Spou:t First Middle L.act
Mailinc Addreati (Numbrr anJ �'uee4 riiy, slale, nnJ'LIP cak) � S:une:u pmpenv addras
-- Social Security NumbcY(Izce 5"digi�i--' � Driver; Cicen.USta[e�lD t:umber-pu� 5 dieitsl— -Other (Flcise sp:.:ify irtPsrr4 be!evv) .. --- -' __
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Each undersiLmed certifies, under penalty o( pequry�. that the above and foregoing infurtnation is we and corrzct and that he or she is elieible to
receive the homesiead standard deduction on lhis property. Each undersiened al>o understands that, by claimine additional homestead deductions
unlawfully, he or she may be liable for back taxes and substan�ial financial penalties.
O�.�ner I Sirnemc Untc Tcicphonc
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Spouu Sigu2are � / Uatc Tdcphonc
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