Homestead_McReynolds •, ' %TATE r ORw53'M0e/!w1 TRrA5n IER FORM TS-IA
1/PROVED BY STATE BMRDDrMU!teM.stn FILMUBFD BY fait DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC 6-1.1-2:4,1
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 el er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional identifying information nemsary to allow county government to better monitor homestead
filings.This information will be kept cont dentinl and can only be accessed by authorized county officials.lie Depannsnt of
Local Govermlent Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
McReynolds, Charles A/Miriam Jo
1513 Outer S Main
Princeton IN 47670
3932
_ _ Charles Al Miriam Jo McReynolds_ _ _ _
1513 Outer S Main State Parcel Number Lezal Description
Princeton IN 47670-3465
Illtll�111ltllllll lull IIIIIII IIIIIIIIIII tat IIIIII11IIt II 26-12-18-302-001.997-028 019-01997-00 PT SW 18-2-10.8137 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Mire d rn Joan /"lcKeynoids
-ong Address(number and street.city,sate,and ZIP code) — - —�-Same ns property address ---
/ 1' /3 Smith plain 5t.
First Middle Last
ecLeesed
Mailing Address(Number and steel,city,stale,and ZIP cock) Same as property address
Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sum
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
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner 1 Signature Date
fORM HC 10 19�
P�euriGeE By State Board ot TaR Cammissfoners
CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOR YEAR 19�
ia Be Filee fn Duo���ate
.�
SEE BACK FOR FILING INSTRUCTIONS QIC,� O//�A�:�O
[ 'l -f
�'(We) �-�-Q� Q- ¢' ��� �e"a�-- `�G �ertify that on the 1st day of
nnarch, 19�-2, I, (We) occupied as our principal ace of residence e tollowing described real property for
which a Homestead Prope�ty Tax Credit is hereby being claimed:
I, (We) Q�owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer � n
Property Description in � � /�County �i"na..�C-�.a. Township
Taxing District (City, Town, Township): '7'/LA/k-tr-L�"�r.� Ll�.�nL�
Parcel Number or legal description shown on tax statement:
�i. �LU��.F /d�a-/a 8l37 �4
If buying on contract: Owners name ��� s`^o�e
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:
�hereby certify the above statement is true, correct and complete.
C'�.g.,..�-�e h.�,.�-�e�-�-� ��2�;�U2- ��,
Sneet Aaaress
County Township
Ciry. Sidte and Zip COOe
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 improvemenls
Other Land
Total Land
Residential Improvements
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. , e -'q
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�., �
;1ji+1 ?�'^'Q[�'�
Garage
Other Improvements �, �, tal ��
AUDITUR
T�Improvements - Line (6) plus (7) equals (8)
I aby certify the above is true. correct, and complete.
nsussor
True Cash
Value
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(a) _ o0
(5)
(6) �Saoo
=- 7�h
(�) �
�a� �Saoa
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- ACTION BY AUDITOR -
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Assessed Homestead
Valuation Valuation
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Approved: � � . ,�-�%f-?�iY� -_ Date: / - ��- 77�-
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