Homestead_Reynolds (3) STATE FORM 535690U/3-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6.1.1 22-8.I
:— a IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS i�
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
'^duction becomes more beneficial, there is more incentive than ever 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 receive the benefit and to provide additional identifying
information necessary to allow county government to better monitor homestead filings. This information
will be kept confidential and can only be accessed by authorized county officials. The Department of Local
Government Finance will use this information to create tools that will help county officials eliminate
homestead fraud.
• PARTI: PROPERTY:INFORMATION
Tatnaver Name Property Address Stale Parcel Number Legal Description: ,
John F/Kathy L Reynolds 909 N HART ST 26-12-06-304-002.330-028 CHAS BROWNLEE 21
PRINCETON IN 47670
Complete and return.to:_ hUhIHID]hIfl]UJV] llOIOIlll1,1IDIIII[BOl]EILlu]IIII_
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
•
PART 2: TAXPAYER INFORMATION . ' ' . -
Owner1 First Middle Last
JLYw i Jt-1 L e - RiLQ✓%/Q _/
Marling Address(number and street city,state and ZIP code)
( ) dd
me as property address
Q o c N. I-f cr.) im! � pa A s 1 Ll-7 67 7,0
Spouse 1 First Middle Last
f'//� L -Na /QeAr o u
Mailing Address(number and s'Jsel,city,state and ZIP code) I ✓ame as property address
qI oq N` / ,7 rif' Alp-ci-lum r UJ7b70
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 i attire Date
•
9
FORM HC 10 1979
PrescribeG By State Boam ot ia. Commissioners
To Be FileG in Duplicate
CLAIM FOR NOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19-� ,/
SEE BACK FOR FILING INSTRUCTIONS O�q _ o a 33 0- � o
■(We) �• certify that on the 1st day of
�iiarch, 1��, I, (We) occupied a our principa 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
Property Description in �
Taxing District (City, Town, Township):
Parcel Number � �
`��-O�' Township .
or legal description shown on tax statement:
�a � � �'�/
If buying Ofl contract: Owners name ��� simo�e owneq
Contract recorded in Recorders Office - Record No. Paae
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.
' Individual either owns or is buying under a contract that provides he is to pay ihe property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY
Lantl not exceeding 1(one) acre immediately
surrounding residenti�irg8r�� q�
Other Land � � g,�
Total Land
Residential Improvementsj�i � i97g
�. `V� ��(ticS=tw`�v
� AUDITOR
True Cash
Value
(1) 1�Oa
(p) �^
(3) �`fOd
Dwelling �4�
Garage �5�
Total (6�
Other Improvements
Tr�'-Improvements - Line (6) plus (7) equals (8) �
I�by certify the above is true. correct. and complete.
Slgnamre � Asseuor
Approved
(�)
�s> 3 33 0
ACTION BY AUDITOR -
Assessed
Valuation
�oo
,.�„ ,,,�
.
Date: �! / v/
/
� `� 6
Homestead
Valuation