Homestead_Blythe tlATE I m.M!!:ta lest sArv1 TSlfASULEA FORM 3-IA
xrrarwto nT circa.NMRn or MTalsTx.TM PPF3TIBQI BY TIr orPMEMavt(x LOCAL t VEINNI .'T ra:ANCE a'VI.IL'F.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individual 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 1344-2000 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to teethe the
benefit and to provide additional identifying information nece-:an'to allow county merriment to better monitor homestead
filing.This information will he kepi confidential and can only be accessed by authorized county nfkials.The Ilepanmrnt of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Blythe, Thomas R/Bonnie J
12873 I:75 S
Oakland City IN 47660
4977
Thomas R/Bonnie J Blythe
12873E 75 S State Parcel Number Legal Description
Oakland City IN 47660-8129
i I I III I I I I I I I I I I I I I III I I 26-14-17-300-000.072-006 003-00072-00 PT SE NW 17-2-81.113 AC
a.0 set t ra n set a nn n r a n ur n r nr
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
hoWL4 s a 6 y E
•fg Address(number and street,city,state,and ZIP code) - - 0 Same as property eel - - — - -
1a873 E . 767 S. DtklaxJ Try , SN x7440
Spouse First Middle Last
o,UNI L J ea-r BL-yrhr
Mailing Address(Number and street,city,state,and ZIP code) ® Same as property address
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 Si a Date
FORM HC 10 1979
Prescribed By State Board of Tax Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 -Zf J
SEE BACK FOR FILING INSTRUCTIONS OQ
003- OWN --
�(We) R. t- A6 &nlllh!o / certify that on the 1st day of
March, 19-- I, (We) occupied as our principal place of reb4dence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned d� - /���_
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description
Taxing District (City, Town, Township): °-
Parcel Number -
If buying on contract: Owners name
my -�- Township
i � 1
or legal description shown on tax statement:
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.
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 -
F
te) E
True Cash
Value
Land not exceeding 1 idiately
surrounding residential improvements
(1)
Other Land MAY 2 ' 1979
(2) to d
Total Land
(3) ✓c6 O
a p
Residenti rmyv�
Dwelling
(4> s90
AUDITOR
Garage
(s) - O
(6) S9 O
Total
Other Improvements
(7)
Tr -' Improvements - Line (6) plus (7) equals
(8)
o�
(8) .3 d 2, 0
I Wuy certify the abo is true. corre and complete.
Signature of Assessor
fTIf1Al
..
_ RV At
In IT(1R _
Approved
Assessed Homestead
Valuation Valuation
/ 70
�O
190
VOWEA W04111111111111,
S- lf-
Date
Dater J419,27