Homestead_Williams (8) SIAM FORM!"M1 RU f+Y1 TRFASUEFA FORM:SIA
MpRrA'En Fri STATE 11MRnnr Nasrenc.?low rRFAWmnny TUE Dt'Mfl r OF LOCAL GOVERNMENT FIANCE MH.1-2141
•
Gibson County Auditor
101 Main
N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101
PRINCETON IN 47670 Individuals and married couples are limited to one homestead Aandard 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.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify 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 he accessed 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 1: PROPERTY INFORMATION
• Taxpayer Name Property Address
Williams, Patricia A
sl4—lk. :;4 —
Oakland City IN 47660
4972
Patricia A Williams
12730 E 100 S State Parcel Number Legal Description
OAKLAND CITY IN 47660-8119
ltluilu Eitlintlln lln tlnlnuilutilltlnnlltllu EtlEitl 26-14-17-100-001.035-006 003-01035-00 PT NW 17-2-8 3 AC
C1
PART 2:TAXPAYER INFORMATION
Owner I yi First Middle Last
tg Address(number and street,city,state,and ZIP code) ''— _/__ —111 as pmpcfry oddiess
it 7 1/ <1 O /D d s (Oa1Q2(' CLIZ j 7/1/V9‘4
Spouse First Middle Last
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)
Scar
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 I Signature Date
FORM HC 10 1979 to Be Filed in Duplicate
Piescrined By Sate Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19-7� J
SEE BACK FOR FILING INSTRUCTIONS
�'(We) ., certify that on the 1st day of
March, 19�`L, I, (We) occupit�s our priR �jp al lace of residence the following described real property for
which a Homestead Property Tay��edit�hrreby being claimed:
1, (We) M owned ot�lo 7 -/QD
❑ are buying under contract
❑ have a beneficial inter st n the taxpayer
Property Description in � � County Township
Taxing District (4&ky mew ,,- Township): n
Parcel Number
If buying on contract: Owners name tree simple owner)
or legal description shown on tax statement:
Al LIJ
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
Aik hereby certify the above statement is true, correct and complete.
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 JUW �'1079 Dwelling
arage
Other Improvements AUDITOR
T '-' Improvements - Line (6) plus (7) equals (8)
l0by certify the above is true. correct. and complete.
of
True Cash Assessed
Value Valuation
Homestead
Valuation
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- ACTION BY AUDITOR -
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Date: _lP - Z 7- 7 4