HomeMy WebLinkAboutHomestead_Collins (6) 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 8l
(/��� SEE BACK FOR FILING INSTRUCTIONS
r (We) �' "— /��j .�}�_ `' �' certif that on the 1st day of
larch, 19AL, I, (We) occupied as<bur principal place of rest tdef ce 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 id c-n` County 7fre2.4--4 . Township
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Taxing District (City, Town, Township): !/QA-4.
Parcel Number or legal description shown on tax statement:
(Pk oggZOX a7-/-/ 0 6 o: 73
If buying on contract: Owners name stet 51mple °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
l hereby certify the above statement is true, correct and complete.
re.
c : .• // Rai? - �97 � 7iS�d
gnat, 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 Rot exceeding 1 (one) acre immediately
surrounding residential improvements - (1) 3 O o / 7 o / 70
Other Land (2) S/ e-O / 7 o o-JB90
Total Land (3) S& o--o `'fib 40
Residential Improvements 'LEG a algeg (5) o �jj
- VAR 17 19°-r�tal (6) to !o G o /'% ������
Tp' ' Improvements - Line (6) C1))%;l Improvements
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it . -,(8) 7 ' 7o q ci
L by certify the above is true. corr•c . and co plete. 31'70
\ 3 - a - 81
Signature of Assessor (- ,� Date
- ACTION BY AUDITOR -
Approved: Date:
510111ORM!IM it'/1-u4) TPSAS5Pla FORM 11A
APPROVED 1W Sr0TE BOARDOF AMOUNTS.211N Plr-*RIBED BY THE OEPARMNTOF IUMI tnwELNMrAT FINANCE MFI.I-r4.1
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 eser for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
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HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
Glint,.This information will he kept confidential and can only be accessed by authorized county officials.The Depanuent of
Local Goverment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Collins, Bryce E/Virginia R
Well n09-074 009-03120-00
Ilaxleton IN 47640
2894
Bryce E/Virginia R Collins
2470 E Dead Level Rd State Parcel Number Legal Description
Hazleton IN 47640-9273
III raI III nI I III 'n III I I III I 26-02-27-100-000.103-017 009-00103-00 PT LOC 2 FR 27-1-10 57.50
n ra
rft t11 rttaut rat ttil `r AC
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. • PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
din .Address(number and street,city.sate.and ZIP cede)•—--- — - -
N 7-v " ,e6,4-b 1-9.._t/e.l fl'D Ala? 4.. n! td `e G Y U
Spouse First _ _ Middle �� Last
Mailing Address(Number and street,city,state,and ZIP code) 0 Same as property address
&W i l e A izAt 0 Lc,c•a.<.gift -1f nre,,/,_,,Ta tiiz 4,rp v G Pd
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
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