HomeMy WebLinkAboutHomestead_Rothrock STATEICIRN1!I7MIR21•4M1 MALARIA reR.N73-IA
.VPRIT'En BY ST1TGRM11D(W115CNt.!nM PRFSOImm➢nY nor DEPARTMEITUFuxtu twtrTMCM FINANCE IC.-1.13:-R.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to or homestead standard deduction. As the receipt of this deduction becomes
more beneficial.there is more incentive than net for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
4111 - HEA 1343-3009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to creche the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kepi confidential and can only he acre:sed by authorized county official.The Depanntem of
Local Govcmmwnt Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Rothrock, Debris Maxine Life /2.Z 376 2 c o S .
Est/Sherry
Oakland City IN 47660
5625
Debris M Rothrock
12289 E 200 S State Parcel Number Legal Description
OAKLAND CITY IN 47660-7681
l.lullntltIlntllIIllntlu rlrilII1II1nn111u 1t1,1IIlIIlII 26-14-19-400-000.848-006 003-00848-00E SE 19-2-85AC
5
PART 2: TAXPAYER INFORMATION
Owner I 1 First Middle Last
DeloN , s M!�faxinie oTH R_oe_ IC
�g Address(number and street,city,state,and ZIP code)— --- - -— ---- Same as property eddies— - - _. —" - -- '
laa89E 4130 .2) . cOneA9 r e , 11 q , tit - I/7c,,a-e- 7b3 /
.
Spouse First Middle Last
AeCCagc. J •
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sae
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
unlawfidly,he or she may be liable for back taxes and substantial financial penalties.
Owner I/SSiignature Date
•
FORM HC 1D 1979 fo Be Filed in Duplicate
Prescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 1927 J
SEE BACK FOR FILING INSTRUCTIONS
�r✓-J 003- O Og1-l4 - ov
J�(We) �ae et � \� certify that on the 1st day of
March, 19 -19 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 a� - is�i9- "4 � —' �-
❑ 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
Township
or legal description shown on tax statement,
%s J f % IF- .2 - 8 5� �
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.
i i %-i .'Nr
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
tj E3
Residential Improvements HMO, Dwelling
WAY j 1979 Garage
7 Total
Other ImprobErhenI ,
To+ 1, Improvem is Line (6 i,�L�quaIs (8)
1 Wby certify the abo\A is tr8 e. IYgrrect.oand complete.
Signature of Assessor
True Cash
Value
(2)
(3) j3a0
(a)
(s)
(6)
Assessed
Homestead
Valuation
Valuation
/70
— -; 33 °
%71111///
(7) / ,/, `f/ 0
(8) 3
- ACTION BY AUDITOR -
Date
/
Approved: °f . Sl- / t�.� Date: