HomeMy WebLinkAboutHomestead_Harvey FORM MC 10 1979 — . To Be Filed in Duplicate
Prescribed By State Board of Tax Commissioners --
• CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 77.
.
// SEE BACK FOR FILINGANSTR{JCTIONS -
(We)— �Je certify that on*the let day of
.arch, 19 , I, (We) oc upied as our principal place of residence a 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 inter s in the taxpayer /f
Property Description in County e.t.a .L-�J Township
Taxing District (City, Town, Township): r
Parcel Number or le al description shown on tax statement:
,--C- /o
If buying on contract: Owners name flee simple owner)
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
i—T hereby certify the above statement is true, correct and complete.
/
'Signature / Street Address City. State and Zip Code
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 -
True Cash Assessed Homestead
Value Valuation Valuation
Land not exceeding 1 (one) acre immediately
surrounding residential improvements (1) 4' &0 a O--O u-d
Other La lift (2) _0 — "_ 0_
Total Lan j (3) /to B� 40-0
Residential Improvements l 1979 Dwelling (4) 9' r7
Garage (5) —O. / A
a �� Total (6) sO5o �o /StSQ b° / w--
Other Ima � s / ���� 4 J
(7). . / TO S oVe) '�
MOImprove ents Line t I4 (7) equals (8) (8) 7`/.Z d /c3 7�
by certify the a vve is true. corr t. and complete. 1 /
Signature of Assessor / Date
O — ��
O n ((- ACTION BY AUDITOR -
Approved: /1 - 9 9 1 ,cFato---4---- Date: —C—f 7
ST'TE EftM5'N Ill'/4041 TPIASutrR FORM MA
.APPRP'ED BY MATE BOARD Of AMP\TS-V■N Pita-RIM)DV nil DEPARTMENT({tq'AL(" RVMEAT FINANCE IC LI.I-l'-AI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud.Ilomestead fraud causes higher tax bills for all;therefore.
III HEA 1344-2000 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.Vries information will be kept confidential and can only h-arce.sed by authorised rnnnw officials.The tkpanmenl of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Harvey, Delta M
Box 211 ^\(...--
Francisco IN 47649
4571
Delta M Harvey
Box 211 State Parcel Number Legal Description
---- - -•Francisco-LN-47649-021-1- - --_- ' - - ---- - - - - - -- -- - — -
I rIl rIIurIrIInrIrrI�r�rr IIurr rIriulllnlllulilu tllt�t tll 26-13-20-101-000.113-005 012-00113-00 PARKVIEW 10
X
PART 2:TAXPAYER INFORMATION
OwneCI First Middle Last
J f/4 MAY efrEvril
mg Address(number and street.city, te,and ZIP c c) ❑ Same as property address
30( hue s4ier � rs�� GPI c '
-
Spouse First Middle Last
Mailing Address(Number and street.city,state,and ZIP code) 0 Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
a. I
Scar
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
unlawfidly,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date
\ )
PART 4:ADDITIONAL INFORMATION
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