HomeMy WebLinkAboutHomestead_Mitchell (8) sl Mt FORM 53 4*.R:1,-n, MIASMA cr1101,71.0
APPA*'En BY StsTE la,iRO OrACT[1.1t Inn PIEYAT(D UN TIM DEPARTKEW OF LOALC.mERNMFICT FD4A\CE It t.t-_4.1 r
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 eter for homestead fraud.homestead fraud causes higher tat bills for all:therefore.
HEA 1344-200c requires taapaycrs who receive the homestead standard deduction to verily that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county go.matt to better monitor homestead
Ming,.This information will he kepi contidemnial and ran only to accessed by authorized county officials.The Ikpanntent of
Local Government Finance will use this information to create ours that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
• Mitchell, Gladys M
203 li Clark
Princeton IN 47670
3012
Gladys M Mitchell
203 E Clark State Parcel Number Legal Description
Princeton IN 47670-2109
lt ltrlltrrltllt rlr trlllrttrt lt ltttlliltt tltlttll Ilttttill 26-12-07-401-001.814-028 019-01814-00 WILLIAMS 2ND 9 PT
PART 2:TAXPAYER INFORMATION
Owner I ��aa First �j/ Middle Last
LS Lh D YS /' /J-a J--/ 7 TG it E Li.-
all teg Address(number and street,city,state,and ZIP code)(� RI Same as property address
2-o3 G. C' Lh271 ST , PR /A✓GETOlvr- N'D_ L('7L>m - ?) f
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please spu ity in Pan 4 below)
saw
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 I Signature Date
•
FOPM HC 10 1979
Preuri�eE By State BaarG o� Ta. CommiSSionea
io Be FileO in MDlicate
CLAIM FOR HOMESTEAU PROPERTY TAX CREDIT FOR YEAR 19 ?9 /
SEE BACK FOR FILING INSTRUCTIONS D��— D( �I'I' O�
�-�,� -� �-,� � ` . .
'(We) � �� � —� certify that on the 1st day of
arch, 19 I, (We) occupied as our incipal place of residence 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 '
Q�/ i - ..,_ ' 1
Property Description in h!-c�(i-a-o—+�� County �-�-�'�O-� Township
Taxing District (City, Town, Township): '
Parcel Number or legal description shown on tax statement:
`�iw.. . �.�,...d�- Q-.oLcC • 9 i'1 �i.
If buying Ofl contract Owners name ��ee s�moie owneq
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 Township
�hereby certify the above statement is true, correct and complete.
'r�� \� c
�!+-�a.�,- o�- 3.0 3 �, C,'�,t,ti,� �
' 'Sipnamre Sueet Atltlress
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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 -
True Cash
Value
Assessed
Valuation
Land not exceeding �(on� acrq im�te�
surrounding resident{��i' im rovet�nts (�) a 030 ( 80
Other Land (�) �a— —o—
Total Land
JIJ�� %,<j Ii�J
Residential Improvements �
� i /���./i��
I
� AUDiTOR
Other Improvements
T^'-' Improvements - Line (6) plus (7) equals (8)
1�6y certify the above is true�orrect. and c
�
Sl9na:ure o1 nssessor
� �a�
Homesiead
Valuation
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