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Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
, PRINCETON IN 47670 Individuals and married couples are limited to one home ead standard deduction.As the receipt of this deduction becomes
di more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires tavpa■crs who remise the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kepi confidential and can only he accessed by authorized county odbcials.The Depanment of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
FILE !e Taxpayer Name Property Address
; ) Erdell, John H
RI 13ox 107
APR 7 LULU Oakland CitylN 47660
627
y 858 9 E siebY
—y
John H Erdell 7aam . IQ�+j. Q\L
8589 E SR 64 GIBSON COUNTY AUDITOR State Parcel Number Leoal Description
Oakland City IN 47660
26-13-22-300-000.287-006 003-00287-00 PT N SW 22 2 9 159.202 AC
D-6 C-1
X
PART 2:TAXPAYER INFORMATION
Owner I First Middle /� Last
txp
- •t eldress(number andmeet,city,state,and ZlP code) - — -- — —geSume us prupcm-addrLss-- - --- - -- — —
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 Liccnsc/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sore
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 eliuible 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 rII Signaturee� / Date
-d
FORM HC 10 1979 To Be Filed in Duplicate
Rescritted By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 197, f/
SEE BACK FOR FILING INSTRUCTIONS
`�(We) . /b'� , certify that on the 1st day of
arch, 19 I, (We) occupied as 61ur principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned 66 - /3 -aa - �� _moo, ':2P7 �
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in
Taxing District (City, Town, Township):
Parcel,Number
If buying on contract: Owners name )tee simple owner)
my Township
or legal description shown on tax statement:
as - .:2- 9 80
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:
hereby certify the above statement is true, correct and complete.
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
F1 L E
Land not exceedi g�L (one))_ immediately
surrounding reside °h'tlal ihiprbXerrents
Other LanWd
Total Lan /ovelments Residential Im AUDITOR Dwelling
Garage
Total
Other Improvements
Y� improvements - Line (6) plus (7) equals (8)
I°!!liroy certify the/,above is true. clyrect. and complete.
Signature of ASSeSsor
True Cash
Value
(2) /S3./o "
(3)
(4) d'o8o
(5) — O-
(6) X080
(7)
sZ 10(00
(8) / 0 O
- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
II
oate
Date:� 7Q