Homestead_Arendell 5151EI O10MJ!5s0C/fdt nnFALUf KIN TI-IA
r Arnim ELI BY STYE BMPWOr NCTA INTS."%iv PltirlItlD BY mr DEpMMINT OF LOALrovENNMnT FIANCEtc LL1-_aI
Gibson County Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
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 e'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 verity that they are eli_ible to receive the
benefit and to provide additional identifying informmmn necessary to allow county goverment to better monitor lomesead
flings.This information will be key confidential and ran only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help roomy officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_
RI Box 216 ('^` � )1�
Oakland City IN 476rdL
4723
State Parcel Number Legal Description
Oakland City IN 47660-8428
I I III I I I I I I I I I I I I III I III 26-13-24-300-000.006-006 003-00006-00 PT SW SW 24-2-9.96 AC
I n nI I nI a lie el ee ee el I ee n I I el eo L C-1 D-6
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please sptcifv in Part 4 below)
Slate
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
illi„
FORM HC 10 1979
Piescrioed By State Board of Tax Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 ?9 /
SEE BACK FOR FILING INSTRUCTIONS J
�(We) �
occupied asOou /Principai place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
1, (We) 03 6wned 003" D00f t
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in County, f "� Township
Taxing District (City, Town, Township):
Parcel Number or legal description shown on tax statement:
�� JZ.j -,y A6",Pq dV--:2 -9 .96_'j_
If buying on contract: Owners name 0- simp1e
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.
lk
County Township
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
Land not exceeding 1 (one) acre immediately
surrounding resident' Im rovements (1)��
Other Land o (2)
Total Land (3)
Residential ImprovementsJUL 1 Dwelling (a) 9sao
Garage (5)
Total (6) 9s z°
Other Improvements AUDI
TOR (7)
T I., Improvements - Line (6) plus (7) equals (8) (8) 9Sao
by certify the above is true. correct. and complete.
Signature o1 Asseswr
ACTION BY AUDITOR -
- Approved
Assessed Homestead
Valuation Valuation
11D -/&V-
11 D 1z-e�
114
7 -/0 -7 9
Date
Date: