HomeMy WebLinkAboutHomestead_Davis�..._— FORM HC 10 1979 To to Filed in Duplicate
Prescribed By State Board of Tax Commissioners
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CLAIM FOR HOMESTEAD PROPERTYrToX, CREDIT FOR .�19 8a
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SEE BACK BACK FOR FI LING INSTRUCTIONS
We) "'a'" ` ' 6-ka_..) O'-„- r • certify that on the 1st day of•
arch, 19 S - 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
-0 are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in �-�-�- County 6 Township
Taxing District (caw-Town, Towip):
Parcel Number or legal description shown on tax statement:
Pt- . c5E7/S4 a - 3 - 7 c• 037Z .
If buying on contract: Owners name pee simple owner)
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
I hereby certify the above statement is true, correct and complete.
0
! . ti
'Signature Street Address City, State and Zip Code
• 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 Homestead
Value Valuation Valuation
Land not exceeding 1 (one) acre immediately
surrounding residential improvements (1) Soo /7o 77ro
Other Land (2) 8 So a 8 0 V70
Total Land (3) / 3 60 610
fr. ..pr/// // O
Residential Improvements (4) ,rs8-3-o /�;7ii,,;/;%Z' ,,,,,,u;�..../
Dwelling i% i i iiiaiiii��iiia�•
Garage
(5) — iZ%r%% % :1 14 2
(6) ,- 3 0a.z 1 o C3 /o 'gib Total %%%
Other Improvements (7) 3 a 2 o 4600 ,i
Total Improvements - Line (6) plus (7) equals (8) (8) 14-0-CS
I 4110by certify the above is true. correct. and complete. .1 '7 27 0 .9.0 7
/o 0-0
Signature of Assessor Date
- ACTION BY AUDITOR -
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Approved: Date:
r STATE FORM 53"..414:0-u.1 WARMER N0.V 11A
A PritnVED BY STATE OMROff Nft\TS.9v rtJXTUBFDDY nit BrPARTN[Yrri LOCAL CAWt-Mrnn FI:A\Lt IC*-1.1-1Z4.1
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 deduction becomes
more beneficial,there is more incentive than ner for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to reecene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
• tidings.This inlbnunlion will he kepi confidential and can only he accessed by authorized county officials.The Ikpanmem 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
_ Davis, Cecil W/Sharon E
R I Box 163 /��/��//�-Y .
ws-
Oakland City IN 476fs0-T
- — , 8454-- - -- — -- -
Cecil W/Sharon E Davis
5403 S SR 57 State Parcel Number Legal Description
Oakland City IN 47660
26-20-02-403-000.057-003 020-00057-00 PT SE 2 3 9 5.104 AC
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PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
CECtt- WAN(wE DAQi5
tg Address(number and street city,state,and ZIP code) ..-- ❑ Same as praper y oddicss -- — -- - - - ---
4-03 Sou SR 51 0.11-KIAUIb C nzy IQ 14 "1 (0(00
Spouse First Middle Last
SNARCO E1.. ERT'A `7A-0I5
Mailing Address(Number and street. I.t city,state.and ZIP code) l �me as property address
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 Si turc Date
PART 4:ADDITIONAL INFORMATION
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