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Homestead_Greubel FORM HC 10 1979 / To Be Filed in Duplicate Prescribed By State Board of Tax Commissioners . CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 77 -- — SEE �JBACK FOR FILING INSTRUCTIONS , 0(We) �� 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 interest in the taxpayer Property Description in _vim County Township Taxing District (-City, Town, To3.444&t4p): ' Parcel Number or legal description shown on tax statement: . /at .S'ic4 • ,/-.-,-/ o .3o/4u/ze If buying on contract: Owners name flee 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 hereby certify the above statement is true, correct and complete. ,MM// e6 ).±._,. P //it Frst wav bsia,1t 7,, J 9-7635 'Signature Street Address City.$ate and Zip Code • \.7 13 yi -e 06 / 57 Individual either owns or is buying under a contract that provides he is to pa)/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) //00 370 .37° Other Land (2) _ Total Land FILED . (3) // O O a9 70 Residential Improvements Dwelling (4) 949-t-Q,��}o���������� JUL 21979 Garage (5) 1 o 0 1kr.D0�/00000� / Total (6) 5—�-i - 41Vo �r2'0 ibl /`.-- — Other Improvements' '/ AU/ (7) —�`� �i�-O . j/jj�jj To'-' Improvements - fine (6) plus (7) equals (8) (8) s �_ a0 I �by certif above is true. correct. and complete. ti ` ab-3-0 -y t 9 ° .s=� 9— 79 Signature of Assessor Date - ACTION BY AUDITOR - Approved: A''• L . L•.. i Date: �� IF�/ '/ STATE FORM 53549(R3/6-10) TREASURER FORM TS-IA APPROVED BY STATE BOARD OFACCOUYIS.201 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC 61.1-22A.I Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPER'IT O\' ERS • 101 N. Main Street Individuals and married couples are limited'to one homestead standard deduction.As the receipt of this deduction becomes I Princeton, IN 47670 more beneficial,there is more incentive than evef for homestead fraud.Homestead fraud causes higher tax bills for all;therefore, r HEA 1344-2009 and to provide ovide additional taxpayers who receive the anon ece standard allow deduction to verify that they are eligible ni monitor homestead the ® benefit and to prmide additional identifivug information necessary to allow cowry government to better monitor homestead filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of banal Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. PART I: PROPERTY INFORMATION APR 1 1 2011 Taxpayer Name Location Address c. .pfv$.� Greubel, Martha J v w\ 1145 1ST AVE GIBSON COUNTY AUDITOR HAUBSTADT IN 47639 8412 - Martha J Greubel IIDIDIII VIII II I mil 11 111 III II III II ii 1111110.. HI mill II I 11101 Po Box 51 Haubstadt IN 47639-0051 Irtltllrllllllltll1lllllttllllrlllllI'IIII111'I'Illlll"I111111'I State Parcel Number Legal Description 26-19-31-304-000.132-009 PT SW 31-3-10.301 AC , This form MUST be returned to County Auditor's office. . Please do NOT send this form back with your tax payment to the county treasurer. . °-( ..-__-__`__- _____ __--__'._P_ART_2: TA\PAYER1NF_ORlLATIO\------ _ _—_- ,- __ ------ -- -----_ First - . Middle Last ' `/YI/1-2—rit A ,TEA-,c/ a 2 E U s cL Mailing Address(number and street,city,state,and ZIP code) Same as property address Pa. 13 o / S/ �A-uB57A-OT, ZV 476 37 ° Spouse First Middle last — �I- ..---1------------- . - 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) 1 I l l - I I I - � I - 1 site PART 3: CERTIFICATION Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and•dorrect 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 1 Signature Date _ PART 4: ADDITIONAL INFORMATION