Homestead_Tackett STATE FORM!Mt.,R_/YN, TRFAS141$FOPaM TS-tA
APPROVED BY AaF',WOOF AI^T,VESN4V PLEXWnmay nil DEPARTMENT OF LOCAL GOVERNMENT 1S5ANCE 1WH.i-rat
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main ,
CETON IN 47670 . ,IndividuaLs and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
` more beneficial there r more incentive who rec ever her homestead fraud.IIoedurcao fraud V rify th higher to bills for all:therefore.
HEA 1344-2009 requires ore taxpayers we tan cte the homestead nand.I deduction to Verify that they are eligible for al:there the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be cep confidential and can only hr aceesavl by authorized county ofricitis.The Depanment of
Local Government finance will um this information to create tools that will help county officials eliminate homestead fraud.
APR 1 5 zUlu PART I: PROPERTY INFORMATION- :�F; '
Taxpayer Name Property Address .
Tackett, Raymond H/Jean _
—618SON COUNTY AUDITOR 612 S Gibson
Princeton IN 47670 .
1142
Raymond H Tackett
-
612 S Gibson State Parcel Number Leval Description
PRINCETON IN 47670-2406
liluilltt ilullitliti 1lli rrrt1rliluil 11rrrrll 1111111111111 X26-12-07-403-002.826-028 019-02826-00 CLARKSVILLE 8 PT
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORMATION _ c
Owner I // First Middle Last
RAim amp ''7 f�i':7!_? .779ckEI -
g Address(numbci laid street city,state,and ZIP code) E Same as property address
(C) 12- s G/3S6.) . PRipc6tor), -,✓. 4/747C
Spouse First Middle • Last
J0R> F / HC.derfT
Mailing Address(Number and street,city,state,and ZIP code) Er Same as property address
COz S. C
t r /83o? - PRiI.IGG for) ,j,/, L176 7.> .
- .
PART 3:CERTIFICATION-,. r a?,^:, A..1; i, ,- - .
Each undersigned certifies,under penalty of perjury.that the above and foregoing information is tnie 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 maybe liable for back taxes and substantial financial penalties.
Owner 1 Signature Date
.
7*
"/ FOpM HC 1U 1979
� Preuribed By State BoarE ol Ta. Cam.�siar.tro�'�"=
�
To & FileG in Dupliwte
CLAIM FOR HOMESTEAD PAOPEATY TAX CREDIT FOR YEAR 19 'g l �,�
SEE BACK FOR FILING INSTRUCTIONS D�4- oaga�-oO
rv'�,:i, i9�L, I, (We) occupied as oui principal place of residefi�
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 ,.�-�-rM+^� County
Taxing District (City, Town, Township):
`�^-- certify that on the 1st day of
the following described real property for
Township
Parcel Number or legal description shown on tax statement:
1��.�. � ,, ,.�.x�. � .2� $ O�
If buying on contract: Owners name ��� simple o.�e,� "
Contract recorded in Recorders Office - Record No. Paqe
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.
�' "• V �I �, ' � _ D T1" I; I 'J � 1�:_A.�,� ) �
County Township
� `�7E 7J
Giry. State aM Zip CoGe ""-
' 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) �e i�m�te� �
surrounding residential improvements
other �and APR 6 1981
Total Land
Residential Improvements
�+ aUDITOR Iling
Garage
Total
True Cash Assessed
Value Valuation
(t) 1 870
cz� --
(3 )
(4)
(5)
(6)
Other Imorovements (�l
��-T^'�'-��-r ovements - Line (6) plus (7) equals (8) (8)
-• ,+rertify lhe above is true, correct. and complete.
�. • �
Signawre m asseswr
ACTION BY AUDITOR -
(o � o
Homestead ,
Valuation t_
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` Approved: `—�`V • �/• � �� _.+'t_eC. _ __ Date: � J b '