Homestead_Williams (6) • STATE I ORM arM,R_/!WI Tnr VEER FORM:}IA
.APPROVED n1'TIVE BOARD Of MTTRICrS]VV ?EESCRIBIDBYftr DTPARIWVTIIP LOCAL rovrRNMrNTreas4t ICH.I-ra.l
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 bounties
more beneficial.there is more incentive than et er for homestead fund.Homestead fraud causes higher tax bills for all:therefore.
AdaN
HEA 1344-7009 requites taxpayers who receive the homestead standard deduction to verify that they'are eligible to recede the
benefit and to provide additional identifrut^_ information necessary to allow county government to better monitor homestead
filings.This information will be kept conlidential and can only he accessed by authorized county officials.The Depanment of
local Government Finance will use this information to cream tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
—. Williams, David G /0 973– e- Z ihca/K 05-15 iri
RIHox70
Oakland City IN 47660
4387
David G Williams
10975 E Lincoln Hgts Rd State Parcel Number Legal Description
Oakland City IN 47660-7691
I I III I I I I I III I I III III III 26-13-13-403-001.031-006 003-01031-00 PT SW SE&PT SW 13-2-9
r u nr r ur n •.r of f ir r our nt r r nr r \J[/ .867 AC
5
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
�Au1D (,�if.1.1n� rns
gig Address(number and street,city,slate, ZIP code) - - - Ni Same as property oddress
1Dq(15 Li n 111/43 1 oaei_..: 1 Deck amid 0,
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.
Owner Signatu e Date / /'
.
•
FORM HC 10 1979
Prescribes By State Board of Ta. Commissioners
To Be Filed in Dupticate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 757 /
SEE BACK FOR FILING INSTRUCTIONS O0� � 01031 00
�® (We) 4 Z
x,-r' • k-x �6t — —,—dJ certify that on the list day of
7vlarch, 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
❑ are buying under contract
❑ have a beneficial inter st in the taxpayer
Property Description in
Taxing District (City, Town, Township):
Parcel Number
It buying on contract: Owners name life Simple ownerl
Township
or legal description shown on tax tatement:
%des /3 J-
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
reby certify the above statement is true, correct and complete.
n
VIM
Street Address
and Zip
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 Assessed
Value Valuation /10
Land not exceeding 1 (one) acre immediate)
surrounding residentia v (1) 41130
ent �
Other Land p� (2) —0—
Total Land (3) -D
.I +I' -v. 25 i979
Residential Improvements (a) %� X (9
Dwelling
1/J j4�Garage (s) — D —
I/ AUDITOR Total (6)
Other Improvements (7) — 0— a
Tc - Improvements Line (6) plus (7) equals (8) (g) %��O g D
I lcby certify th4above is true. cgfrect, and complete.
Signature of Assessor
Date
as -�9
Homestead
Date: (� 4 171