HomeMy WebLinkAboutHomestead_Brittingham (3) MATE FOR.St'JK11L/ MFASSLLR FORM TS-IA
Arro*En BY t1 ATEbtkO OFMIRr.Nlc,v,w PRE4RIBm BY nit DEPARTMENT OF LOCAL CKJrR NMThr FINANCE 1C11-1.1-2.:41.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and mauled couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ewer for homestead fraud Homestead fraud causes higher tax bills for all:therefore.
® HEA 1344-2009 requires aspa■ers 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
Minus This information will he kept contideminl and can only be 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 I: PROPERTY INFORMATION
Taxpayer Name Property Address
Brittingham, Phyllis
•
R I Ibn 83
Francisco IN 47649
2596 _
Phyllis Brittingham
8450E 500 N State Parcel Number Legal Description
Francisco IN 47649-9249
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PART 2:TAXPAYER 1NFOR\IATION
Owner I First Middle jf Last
+2 //yv,�/� /2p� / Y ��L �GC/j[ r7�Rrjy�
Ma -r(number and street,city,strife.and ZiPeode) _ ___-•_ _ _ ___—_ E-Sanle as pmpcCi ad -
rc 5. 0 c Sco j , '— 77? a41
-
Spouse First Middle Last
Mailing Address(Number and steel,city,state.and ZIP code) ❑ Same as property address
Social Security Number(Last 5 digits) Driver's License/Sate ID Number (last 5 digits) Other(please slwciS,in Part 4 below)
SnIr
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
"etritj
Spouse Si Lure _ d Date Telephone r l
PART 4:ADDITIONAL INFORMATION
FORM NC 10 1979 N-..+ To Be Filed in Duplicate
Prescribed By State Board of Tax Commissioners -
CLAIM FOR HOMESTEAD PROPERTY TAX- CREDIT FOR YEAR 19 77
•SEE BACK FOR FILING INSTRUCTIONS
(We) J/>-a--+e-k_ /6741.12-142-,..71 yJn J certify that on the 1st day of
arch,.19_ 79, I, (We) occupied as our principal pilee 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 - • . •
❑ have a beneficial inte st in the taxpayer - - - - - - -
Property Description in County (/f'o—a— --1--- -" "'' Township
Taxing District (City, Town, Township): U
Parcel Number or legal description shown on tax statement:
at. FIE v,/.• 97 c //0 -/ -9- Asp
7:‘ 6
If buying on contract: Owners name nee 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.
ae.4 gii- led-s-s,--- I i;1 d AttiCeae-r''Signature Street Address r 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) .5-4-0 '/70 �/////70///�
Other Land _� (2) 9 9 0 •3 so-. --;/An%"i%";z
Total Land fi rE V is (3) /4 90 ��
Residential Improvements _ Dwelling (4) S0 j/�/j
ali. 3 0 1979 Garage (5) 4Z b'O jj��� j� ��9, 0/4
Total (6) 40/ 3 /7 - :et a3o
Other Impro vbm / / t-e (7) 429 o 4"6-4-e-
T'l^ lm rove erf( nts - Line (6 7) equals (8) (8) // 0 2 0 6-9.6
P UID�(y(
ileby certify the a ve is true. corre t. and complete. .545-0 .
Signature of Assessor Date
O - ACTION BY AUDITOR -
Approved: /f . �$2 ,r„.„.„„.... - - • Date: 7,.is�ij -