Homestead_Coleman start togs.•!.w+,IL'/uYt rnLSSUIpn FORA 73-IA
AIIrfEO By MAIL BOSRD(N AM1rt'MS."no I11E4RNFDBY fir DEP/M.4E 4TO/LlC:AL CAS^_LNMIWT FINANCE M 4-I.1-22-1.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
^ 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 ner for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 134-1-2009 requires taapayen who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information neenowy to allow county government to better monitor homestead
filings.This information will he kepi conlidemial and ran only be acre>sed by authorized county officials.The Ikpannenl of
Local Government Finance will use this information to create tools that will help county officials eliminate tnnnestcad fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Coleman,Berry-&/ Nancy S
�2C..4 a�S ed 721 S 1300 F
Oakland City IN 47660
4974
Nancy S Coleman
721 S 1300E State Parcel Number Legal Description
OAKLAND CITY IN 47660-8131
Itll r��rlr�t��l rr��t t��tt r�t7�t trt��t r��rrt IIIilI7lt tt��t tt��� 26-14-17-200-000.22006 CCO13-00221-00 PT NW NE 17-2-8 1.74 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
IJ A1JCy S @o1,.EIvyet 1 _
—— �:g Address(number and street,city,state,and ZIP code) g Same as property address — - - -
Spouse First Middle Last
Mailing Address(Number and street city,stale.and LEP code) ❑ Same as propeny address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
SOX
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
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date
FORM HC 10 1979
Prescribed By State Board o: Tax Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 J
SEE BACK FOR FILIN N
,� 003- �ooad -1 -00
(We) cer' that on the 1st day of
March, 19 I, (We) occu ied as our princ al place of residence the followin scribed real property for
which aHommestead Property Tax Credit is hereby being claimed: U
I, (We) caned // / �7-43G{J —(�CYJ o?of/- �(O
❑ are buying under contract Olcv�
❑ have a beneficial inte est in the taxpayer n
Property Description in
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners
Township
or legal description shown on tax statement:
Contract' recorded in Recorders Office - Record
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
certify the above statement is true, correct and complete.
Street AE ess City. to an i0 c,cMae
476 66
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.
FI L F FOR ASSESSOR'S USE ONLY -
"U �
1 197`9
True Cash
Value
Land not excee 1 ne),�ag�e immediately
_ surrounding r nti im9wements
(1) .S0
r
Other Land x
(2) /6")-o
Total Land
AUDITOR
(3) Is-A0
Residential Improvements
Dwelling
(a) O
(5) O
Garage
/? 9 C0
Total
(6)
Other Improvements
(7) 0
improvements - Line
(6) plus (7) equals
(8)
(8) __Z/ / O
I hereby certify the ab a
is true. corre . and complete.
Signature OI ASSessor
_ 0!`Tlrl Al
RV Al IfIITlIR _
Approve_
Assessed Homestead
Valuation Valuation
Date
Date:
