Homestead_Bane (2) FORM HC 10 1979 To Be Filed in Duplicate
Prescribed By State Board-of Tax Commissioners T - --x.,
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 77
/�— ET BACK FOR FILING INSTRUCTIONS
Ne) w-�n C-a) w • f��� certify that on the 1st day of
rch, 19 I, (We) occupied as out principal lace 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
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❑ have a beneficial inte st in the taxpayer
r
Property Description in County Township
Taxing District (City, Town, Township): CPIC
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Parcel Number or legal description shown on.tax statement:
iYet "het /oat /—/O / .239Q.ch-ate
If buying on contract: Owners name tree 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.
y-. X23-a.e,_z.� e /
'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 -
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True Cash Assessed Homestead
Value Valuation Valuation
Land not exceeding 1 (one) acre immediately
surrounding residential improvements (1) dS"O-O /10 / O
Other. Land (2) /AO I o
ral u (3) 6ao )$stdential lmprovemen Dwelling (4) 02419/0
/O
Inv 1 4 1979 Game (5) —O —
Total (6) 02 7 9/ O ---- 4451X)
r rpr� a (7) — O — —0—
Tr_ Improveme ;.lJ a (6) plus (7) equals (8) (8) etl/9/O 73&7
�ttC�l f L��
1` by certify the abov is true. correct. nd complete. �/,�Go
� L LAJ /o -7y
Signature of Assessor Date
- AC ION BY AUDITOR -
Approved: le• 9• Date: __..51"/�f•"77
SLATE FORM n..0C/4n1 TREASURER POR4 73-IA
.VPKPED By STATE MIND OF ArCUUNTSFm PI/SCRIBED BY mE DEPMD @YT(K LOCAL CMRR:MUTT FINANCE IC I.1-224 I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead wandard 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 134-1-2009 requires=payers who receive the homestead standard deduction to verify that they are eligible to teethe the
I • benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
�7 i,f filing-This information will be keg 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.
APR 14 ZULU PART 1: PROPERTY INFORMATION
Taxpayer Name Proles ' • ddress
`j-na ig Bane, Dennis D
O - RI Box 127B
— GIBSON COUNTY AUDITOR
Patoka IN 47666
2014
Dennis D Bane
3584E McRoberts State Parcel Number Legal Description
Patoka IN 4766691 •
IILIIIlllIlIIlIlIIlllIIltIIItlltlIIlLLllLdrJIIIEIILIIlI 26-05-57-102-000.022-017 000-00022-005 MD 1021102.207 AC
C-1
PART 2:TAXPAYER INFORMATION
Owner I First Middle 15/4-71/r Last
g Address(number and r u e—e city i r a t e,and ZIP c o d e] _ - _ - _ —_❑ Sonic as proper:nddr s -_.. ___ _. —
3 5 8 / f 10.86 e fob- 2'i✓ x/76 6 6
Spouse First Middle Last
Mailing Address(Number and street,city,stale,and ZIP code) O 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)
sox
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjuy.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 tenB / ) Date
( )
PART 4:ADDITIONAL INFORMATION
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