Homestead_Memmer (2) •
:CIVIL FORM 5350,111:/sant TREASURER FORM:54A
APPROVED BY SIAM MSRoOF✓rTRINTt YN PRESTIBHI BY ME OEPARTMENT(W LOCAL CawRY'MrHT FIANCE ICl-1.1 -AI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sundanl deduction.As the receipt of this deduction becomes
_ more beneficial,there is more incentive than net for homestead fraud.Homestead fraud causes higher in bills for all:therefore.
HEA 1344-7009 requires taapa)crs who receive the homestead standard deduction to verity 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 kept confidential and can only hr a(MSC('by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Memmer, Steven A/Teresa E
R I Box I I
Oakland City IN 47660
4941
Steven A/Teresa E Memmer
76 S 1150E State Parcel Number Le2a1 Description
Oakland City IN 47660-8606
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C-i 00019-00 PT NW SW 7-2-81.092 AC
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PART 2:TAXPAYER INFORMATION
Owner I First Middle - last
}even/ A . ()emme, r
•ng Address(number and street,city.state,and ZIP code) . Same as property
7� . 1156 c d)AKIANd e 7t1 IV 474Go
Spouse First Middle Last
/ere so ,C• (hemmer
Mailing Address(Number and street,city,state,and ZIP code) AMI-Same as property address -
7/i . 1 156E U AKiafvd ( r? j Zrl L194a n
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.
Ow r I Signature Date
•
•
•
FORM HC 10 1979
Prescribed By Stale Board at Tam Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 -1-
SEE BACK FOR FILING INSTRUCTIONS
(We) .t- J1 ym/" "' certify that on the 1st day of
arch, 19 I, (We) occupied as our principal place of residence the following described real property for
which aHommestead Property Tax Credit is hereby being. claimed:
I, (We)Z. owned Ol G -�i-� 7-
❑ are buying under contract - -
❑ have a beneficial interest in -the taxpayer
Property Description in J� County
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners
pee simple owner)
Township
or legal description shown on tax statement:
p N W'14 -S 7- a -8 1.09 2
Contract recorded in Recorders Office _ Record No. J Page I 0l0-`
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 TRwnship9
MR
hereby certify the above statement is true, correct and complete. lC l�
AUDITOR O s
# / PZ /
City. State and
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
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other Land
Total Land
Residential Improvements
True Cash
Value
(1)
(2)
(3)
Dwelling (4)
Garage (5)
Total (6)
Other Improvements
T_ Improvements - Line (6) plus (7) equals (8),
1 by certify the above is true. correct. and complete.
Signature of Assel.,
(7)
(8)
- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
Date
Date:
3-9 -1&1