Homestead_Page _ STATE FORM 5356011Or 8-10) TRFASCRFA FOLM i"tut IA
APPROVED BY STATE BOARD OF ACCOUNTS,?OM PRESCEWW BY THE DBAEWE\T OF IDCALLOVOf.''MEYr FLYA'& IC(-Lt- ti
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
•101 N. Main Street Individuals and married couples am limited to one homestead standard deduction. As the receipt of this deduction becoes
! Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;there fre,
f--- F HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they an eligible to recei a e
( flingst and to provide additional identifying confidential itial and can necessary c allow county government co county o to better rn a De homestead
FILED filings.This information will be kept confidrntial and can only be accessed by authorized comty official The Depa me of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fad.
PART I: PROPERTY INFORMATION
_ APR 7 2011 Taxpayer Name Location Address
C 14 Page, Kenneth Wayne/Judith Kae-
%�"w 3717 S SR 57
GIBSON COUNTY AUDITOR OAKLAND CITY IN 47660
4960
Kenneth Wayne/Judith Kae Page
IIInlll]DIIIVIII �IIII II_DIIIIIDII. II IIIli II_III�III IIIIII01111IUI III III
3717SSR57
Oakland City IN 47660
State Parcel Number Legal Description
•
° 26-13-35-200-000.647=006 / PT NW NE 35 2 9 10.39 AC C-1
— _
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.
�_�__.,�{_ _J'ART 2:TAXPAYER I,MFORMLYTION__—_
O _r 1 ° - First _ Middle - -- - Last
e ne - k . �� ne w e
Mailing Address(number and street,city,state,and ZIP code) 12-,Same as propgh address
n4 )4. 1 (/'
Last
d ______ _p _,...._ .
Mailing Address(Number and street,city,state,and ZIP code) ' aroe as prope dress '
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 Sign urn Date
FORM HC 10 1979
Prescribed By Scale Board of Tax Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 191 J
SEE BACK FOR FILING INSTRUCTIONS
0141 po 3 - oo �v�1- oa
'40 C141
�\ t �1L %�`�� rQ_ y�l� certify that on the 1st day of
March, 19 I, (We) occupied as ur principcVplace of residence the f (lowing described real property for
which a Homestead Property Tax' Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial inter st in the taxpayer
Property Description in -�11 County Township
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name (tee simple owner)
or legal description shown on tax statement, 0 .. a Q, V '
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: County Township
�ereby certify the above statement is true, correct and complete.
Street AddreR 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
Value
Land not exceeding 1 (one) acre immediately
surrounding residential improvements (1)
Other Land g
Total Land L (3) 0.9 0
Residential Improvements JUN 2'1 1979
D well ing
(a) —1,7-1.3o
oo
arage
(5) — o
(s) I97�3o
// ,
AUDITOR
otal
Other Improvements
(7)
improvements -Line (8) plus
(7) equals
(8)
0 la 2�
ai
(s) a
I hereby• certify th above is true.
orrect, and complete.
Signature of Assessor _
_
ACTION
BY AUDITOR -
Assessed
Valuation
/yo
IdtH� 79°
Date
Homestead
Valuation
Date: / '