Homestead_Brauser .. - STATE FOR1.15i5M(R3/&10) - TREASURER CORN TSIA
APPROVED BY STATE BOARD OF ACCOUNTS.2®9 PRESCRIBED BY T@ BEPARrMEYT OF LOCAL GOVEREMENT FINANCE IC 6-1.1-2241
.. Gibson County Auditor= IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N.Main Individuals and married couples are limited to one.homestead standard deduction. As the receipt of this deduction becomes
Princeton, IN 47670 mom 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 receve the homestead standard deduction to verify that they are eligible to receive the
TT TT,, ' benefit and to provide additional,identif ing information necessary to allow county poernment to bener monitor homestead
(•��- '�-� -' l� i O, ' filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
,�, ,Ly Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. '
PART 1: PROPERTY INFORMATION
NOV l ?. .�� Taxpayer Name Location Address
C _ Brauser, Charles Wm/Judy Lynn -
12102`E HICKORY LN -
GIBSON COUNTY - " . . - OAKLAND CITY IN 47660 . o
-
iiIH liMiii i it iiii iiiiiii11 1I I III T 5757 : " _
- II 111111 Ii iili Ii1Pi--f--, CharlasWmtJudy'Cynnerause I D1 I Iil 11111ii i
12102E Hickory Lane
Oakland City IN 47660-8115 "
IIIII'II"I'III'NI'IIIi"IIIII!III"ilil'IiIlll'lililllIl6il State Parcel Number - Legal Description
26-14-19-203-000.081-006 WCATT ADD SEC A 5/PT NE 19 2 8 .333
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. -
-- PAR _: A. 'A ' I • q I r First
Middle
C/1424 E.S ' W/L L / 'ni .1 ' /Se 4 us Ere:' -
Mailing Address(number and street,city,state,and ZIP code) [a Same as property address' - -
/CZ 10 a' ° L i t /1 ICKO ti- x.A j d'tKL /?IIvTi (/i' Xit) L/XGc) -
.
,)
Spouse _ First o " - -Middle Last
Jac) y _ LYn ri _ /exact Se -
Mailing Address(Number and street,city,state,and ZIP code) Same as property address -
i s i b a E iI 1 ka r Ln: .atiCI khd cf y.xn icy14
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,heor she may be liable for back taxes and substantial financial penalties.-
Owner I Siy attire , Date . a
1 ..
.
FORM HC 10 1979 i To Be Filed in Duplicate
Prescribed By Stale Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 1J
SEE _BACK FOR FILING INSTRUCTIONS _ QQ
A A I- _ om3- 000 1
We) �vva�uea� rA . u v y certify that on the 1st day of
r. rch, 19 I, (We) occupied as ou princi I pl a of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
O
I, (We) ❑ owned :; —/7 — /9 � —ezv- e)
❑ are buying under contract
❑ have a beneficial intM='—,P in yer
Property Description in ounty �� P_ — — �^ • J Township
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners
or legal description shown on tax statement:
Contract recorded in Recorders Office - Record No. Page
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.
®
n
-Signature
Street Address
County Township
City. State and Zip Code
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 Assessed Homestead
Value Valuation Valuation
Land not exceeding e ne)-acre immedia
surrou.nding residential improvements _ i 4/60 -1130
Total Land FILED (3) X� �0111
Residential Improvements .�'•• _ /'♦ �j�jjj�j� jjjjjjjjjjj
iw
Other Improvements AUDITOR (7) -----------
I*y certify e• e, rect, and complete.
Sigmune of Assessor Date
`! ACTION BY AUDITOR -
Date: G �y 79