Homestead_Cain RATE 1-1110151K 01:/.EMI THE SULDFOLM TS IA
.APPMFEn By SLUE WssJO Of MTTr..NTkiu Pt,YTIBm BY PIE DEPARTMENT OF LOCAL GTtfMLKr FINANCE IC 4.1.1-12-.
Gibson County Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard&eduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than eter for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
® HEA 1344--2009 requires taxpayers who receive the homestead standard deduction to serif)/that they are eligible to remise the
benefit and to provide additional identifying infornunon necmmry to alloy county government to better monitor homestead
filings.This information will be kept confidential and on only he accessed by authori,M county officials_The Depanntent of
Local Government Finance will we this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Cain, Curtis/Debra
R I Box 70 A5
Francisco FN 47649
1087
Curtis/Debra Cain
6643 E 450 W State Parcel Number Legal Description
Francisco IN 47649
26-06-20-100-000.081-017 009-00081-00 PT W NW 20-1-9 7.391 AC
Spouse First Middle Last
/JF R R A t
eilyAr
Mailing Address(Number and street,city,state,and ZIP code) flame as property address
S,rn° A irk)Lt.c
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 Signor
/
PART 4:ADDITIONAL INFOR\1ATION
S
FORM MC 10 1979 To Be Filed in Duplicate
Prescribed By State Board of Tax Commissioners .--._' 1 -
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 77
SEE BACK FOR FILING INSTRUCTIONS
(We) F 16 o_. ✓ certify that on the 1st day of
r arch, 19 ,
Credit is hereby being claimed: I33
I, (We) ❑ owned 1,y1/r 1 /
111 are buying under contract /I
❑ have .a beneficial inter t in the taxpayer - -
Property Description in c/ 1 / County 4 Township
Taxing District (City, Town, Township): l/
Parcel Number . _ or legal descrip ion shown on tax statement - --
0- • cu /z 91_u11/4 ,010-/- 9 c 39/
If buying on contract: Owners name (fee simple owner) ',• D tl
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.
et#/ BC 76 9 J,,Pfcir O ' %L. senv
•Signatur LIArr r • 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 imt is _...,,
surrounding resided ir(E��provtent-E-.- p1 (1) 4-0 0 / 70 I o
Other Land U f (2) /o 3 o - r-! '/%a�j.
Total Land (3) /.S3O _SS" i ,� / 1rJr
Residential Improvements (4)r, 42,j:it/Garage� }919 (a) 07/0220 t�f r g (5) -0 - S/r'
AUDITOR
Total (6) aZi�a O u ���n
Other Improvements PPP (7) —0 —
T- improvements - Line (6) plus (7) equals (8) (8) �/02020
I ay certify the ab e is true: correct, and complete.
Signature GI Assessor r Date -
{ - ACT ION BY AUDITOR - 1 Approved: A 0\ i -- 1
Date: