HomeMy WebLinkAboutHomestead_Burkhart FORM HC 10?979 To Be Filed in Duplicate
Prescribed By State Board of lax Commissioners a
CLAIM FOR HOMESTEAD PROPERTY- TAX -CREDIT FOR YEAR 19 3/
/�
SEE BACK FOR FILING INSTRUCTIONS
a\(We) /j_"4_�n—t /`-s-c-grr_.ns_ 9.-- O` 77_,—o-. ± certify that on the 1st day of
—March, 19 Ii , I, (We) occupied as out principal place 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 int rest in the taxpayer r'
Property Description in . °Ai.— - County �/ l�V a-oi. • _ Township
Taxing District (City, Town, Township): /fa
Parcel Number or legal description shown on tax statement:
Q om- • z o c S r b / - 7 0 /3-. 7 7 09 n
- (1A . .Uw t r��F coy-is-/o
} 7 7960 %L
If buying on contract: Owners name tee simple °wner)
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 statements true, correct and complete.
1111+ i ).� 4cao_ c PQ !k-1 a 74 9 0
'5 afore 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) ,So 0
� ./ ��
9z• 3
Other Land (2)
Total Land (3). //'`° --a- --e3ite
Residential ImprovementsF IL ED welling (4) --3,— — jj/� '&
APR 21981 Garage - (5)
%/
Total (6) 0 3vXo - - 9- ._ . • /Fbc
Other Improvements )L 0. l , 1 (7) ' k"D 4rj�j��j��/
I ro Improvements o gs - Line ( (8) (8 Aso /
.3 ei
Signature of Assessor .. Date
ACTION BY AUDITOR -
•
Approved: Date:
STATE IORM!RNA IRE/t- t TREASURER FORM:}IA
APPRoVEt BY STATE BMRO OF AOCCRATS.4.v Prr4AlBFD BY NIL DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC s-it-L'-1.1
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 on for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
HEA 134;-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reecho the
benefit and to provide additional identifying information necessary to allow county gocrmrnent to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Depannaent 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 Proverb.Address
Burkhart, Violet&Janice White
R 1 Box 102
Ilazleton IN 47640
2167 _ . _. _ __
Violet Burkhart/Janice White
4640 E Giro Rd State Parcel Number Legal Description
Hazleton IN 47640-9304
26-02-47-006-000.073-017 009-00073-00 PT LOC 6-1-10
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r tit r III rrr I IF III ot I r r I tttr I I I I I ttrr I rr I t I tt III ttr I r I tr I PT NW FR 24-1-10 7.796 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
— `�( Ajddress(number and Street,city,state,and ZiP"code) ._ _ _ __—n -_ __ '_)_ _ l S/atne au property-address---- - --
1'(c T O �, xll F.X.., - NI- .cncJ ) �Y/KJ r q 7 co `i'D
Mailing Address(Number and street city,state,and ZIP tole) 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)
-
see
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
Spouse Signature Date Telephone
( )
PART 4:ADDITIONAL INFORMATION
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