Homestead_Ross (5)•
MAIL 1010M'3t4 ,R/'+r.i TRF.VUM FOAM 711A
AIflttwEo BTRVEMWI OrMm INTSY'u MA-RIND BY THE DEPARfW•r OF LOALCA\TANMrhr FNNSCE M H.i-:-AI
ounty Auditor
1 1 in'; •� IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
C ON IN 4711240 a, �� Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
j.. 1 _ ' f� more beneficial,there is more incentive than ever for homestead fraud homestead fraud causes higher tax bills for all;therefore.
�\ v . • HEA 134:-3009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
APRu 7 2010 filings.This information will be kepi confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create awls that will help county officials eliminate lwncsrcad fraud.
PART 1: PROPERTY LNFORMATION
—GISSON Taxpayer Name Property Address
COL'i,TY AUDITOR Ross, Glen/Karen G
— 93N
pllinx,I,
Oakland City IN 47660
4285 - _--- ___ ___ _ __ . _. _ _ _ _ _
Glen/Karen G Ross
93 N 1150E State Parcel Number Legal Description
Oakland City IN 47660-8607
ltlnllntilllulllniintinlulinllurlurllrlrr lr llrrltlll 26-13-12-200-000.819-006 003-00819-00 PT SE NE 12293.9048 AC
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
G/e h /POs c
ig Address(number and street,city,state,and ZIP code) - --- —- -0 Same as property address- — - ---
93N /ISOC Cakla::I lift, rN q-7 &o
Spouse First Middle' Last
KaI-erl G, ?os S
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
93W //SOE et/eA 11d 61-Y, "-Ai g7660
Each undersigned certifies,under penalty of perjuy,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 ' ble for back taxes and substantial financial penalties.
Owner 1 Sign u Date rl '
FORM HC 10 1879
Prescribed By State Board of Tax Commissioners
To Be Fled in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 81 I
SEE BACK FOR FILING INSTRUCTIONS J
GWe)— certify that on the 1st day of
lrch, 19? 1f I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned '
❑ are buying under contract
❑ have a beneficial interest in the taxpayer �t
Property Description in —� ° County N-
Taxing District (Cky —Town, Township):
Parcel Number
If buying on contract: Owners nam
Township
or legal description shown on tax statement: LSO
At- -S E 14 ti E r� F r �- 9 • to S° 8
Contract recorded in Recorders Office - Record No
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
I hereby certify the above statement is true, correct and complete.
0 ai
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 improvemenVILED
Other Land
Total Land 1
Residential Improvements
Other Improvements
MAY 11 1
D li
At OVp110RTotal
Total Improvements - Line (6) plus (7) equals (8)
I ®by certify the above is true. correct. and complete.
Signature of ASseSsor
True Cash Assessed Homestead
Value Valuation Valuation
(1) S-00
(2) —
(3) So 0
(4) a 8'LO
(5)
(6) as 840
(7)
(g) a a $ O
- ACTION BY AUDITOR_:
/7o /7o
Date
Approved: Date: