Homestead_Fischer ' MAIL FORM.%N'dirt SAKI TPLAn:RFA FORM 75-IA
VFROVEDDV<IAFE BMPnn'HYYaI<Ta INn PRrgNPFDuvntrtEPAan2Vr14 LOCAL CAVERNMFNT FINANCE IH.LL'J.I
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 ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1343-1009 requires taApayers who receive the homestead standard deduction to verily that they ate eligible to receive the
benefit and to provide additional identifying information necessary to allow county gmer ment to better monitor homestead
filings.'this information will be kept confidential and can only be accessed by authorized county officials.The Depanntemt of
local Goverment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Fischer, Roxana C
f 6-
Oakland City IN 47660
4315
Roxana C Fischer
10712E 125 S State Parcel Number Leal Description
OAKLAND CITY IN 47660-8641
1m1u11um1tllntllnlln mlnlnlllnlnlu mllnmlit titlt�t lml 26-13-13-300-000.322-006 003-00322-00 PT SW 13-2-9.367 AC
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PART 2: TAXPAYER INFORMATION •
Owner I First Middle Last
Cripillgi .1,0-022..U\
g.Address(number an street,city,state,and ZIP code)-- - :` -- -- -Some as property aad±ESC —
1° 7 / g E i 'z) sc S o TJ V) 4-Toii6i 6 y l
Spouse First Middle Last
Mailing Address(Number and street city,state,and"ZIP code) El Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sou
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.
Signature Date
FORM HC 10 1979
Rescribed By State Board of Tax Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19'/9 J
SEE 8 CK FOR FILING INSTRUCTIONS VU-:;, - o43aa -OD
(We) �ertify that on the 1st day of
larch, 19_11__-F -(We) occupied as our pn clpal place f residence the following described real property for
which a Homestead Property Tax Credit i4ereby being claimed:
--,(We) ownbuying under contract YYYboj)i jam
❑ a �G
❑ have a beneficial interest in the taxpayer
Property Description in e—_1850e) County 444;i0-ji- Township
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name Oce simple owner)
or legal description shown on tax statement:
A— d'',-JXt 13 -:2 -9' • 367,KqeF.f
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
hereby certify the above statement is true, correct and complete.
QaaL)14 Ea& PPal B5:4.87A O-AQ6_fJL'0':i QQ 4-
Signatire Street Aaare� ci . care and Zip Cone
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 O
Land not eedi�g 1 ne) I diately
surrounding std nits) Nmproner s
Other Land lam•
Total Land -
l., 19/9
�N2
Residential Improvements
I�. r lbl�
AUDITOR
Other Improvements
True Cash
Value
(1)
37C)
(2)
(3)
37 c)
Dwelling (4)
Garage (5)
Total (6)
(7)
T ^4-1 Improvements - Line (6) plus (7) equals (8) (8) it 300
I10by tify the above is true correct, and complete.
Signature of A '
ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
b
6—
Date
Date: l �y / i %,L