Homestead_Williams (9) SIAM FORM•Vt.,Ru F4'•t TRFASULER FORM Ta-IA
.APPROVED BY SFVE IMRDM'Am ALTS Yix PEINRIBm BY ntr DEPARTMENT OF LOCAL CUxrRNNrwTF<ANCEMa-LI-r4.1
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 dcdtrtion becomes
mere beneficial.there is more incentive than e'er for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to serify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to bear monitor homestead
filings.This information will be kepi confidential and can only be accessed by authorized county officials.The lkpanntent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
•
Taxpayer Name Property Address
_ Williams, Ronnie L/Catherine A y�
RI Box 88
Oakland City IN 47660
4327
Ronnie L/Catherine A Williams
•
10510E 125 S State Parcel Number Legal Description
Oakland City IN 47660-8638
IIIuIIIrllllllllllllllltltIllllrlllalllllllllllrlllll ��� 26-13-13-300-001.032-006 003-01032-00 PT SW 13-2-95AC
V
PART 2:TAXPAYER INFORMATION
Owner I First Middle I I Last
-- I-) el t - -— — - - -- Vim./ I L I� ;
i � '"'�5 .- — --- - -- - --
g Address(number and and street,city,state, d ZIP code)— -M Same as property eddies;
S , o E , 125 KknA C:4y 97(4
Spouse First Middle Last
C,Pc\-1-.erine-
A . lJ 'I I •, n
Mailing Address(Number and street,city,stale,and ZIP code) ® Same as propeny address
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-FS-_,attire a Date
?ORm HC 10 1979 Lo rie r1J.Et1 11'I Uui)J.1CaLe
?resczibed,By State Board of Tax Ccnmissioners /
CIAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19
SEE-)BACK FOR FILING INSTRUCTIONS .' p03- 0103`a,�
p "/
I!e) GU�,IQ�,) \i5?�int ashl A2, o �fy that on the 1st day of
19 I, (we) occupies as our principal place of residence the following described real
property for which a Homestead property Tax Credit is hereby. being c a =ed:
❑ awned
are buying under contract -
�have a.beneficial interest.in.the taxpayer -,.. :...:;_a ,;,; g: -:. '• n;y ;:. >,.,;
Property Description in Coun ty Township
�� .. ,
Taxing District (City, Town Township) : %+-� L /
Parcel thunbes or legal.description shown on tax statement:
If buying on contract: Owners name (fee simple owner)
Contract recorded in Recorder's Office - ..Record No. Page
If any portion of the residential structure or the land, not exceeding one (1) acre that
iJmediately surrounds that structure is used to produce.;ncome, describe the use and portion of
the property utilized to produce in=ane
Any other Counties in which individual owns or is buying real property ::;-,!County
^� r ti i •
Z eby certify the above statement is true, correct and conPlete.
*Signature __: f; ! Street Address .:, _ st ;; : .: :•City,. State and .Zip Code
*Individual either owns or is buying uner a contract that provides he is to pay the
property,taxes,on the .residence, or. has a beneficial interest.in :the. taxpayer.
- FOR ASSESSORS USE ONLY
"..True Cash Assessed Homestead
Value Valuation `J. Valuation
Land not exceeding 1 (one) acre immediately
surrourrding residential inprovements
other Ianl.
Total Land (3)
Residential inprovements `.
_ Ixaellinq (4)
Garage (5)
Total (6)
Other improvements p r. _ :: • _ -
'Ih:a'� Improvements - Line (6) plus (7) equals (8) (8) �11
the above above is true. correct, and complete.
y certify
I
'Qr Date
Sure of Assessor
r - ACTION BY A.UDITnR -