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Homestead_Coomer FORM HC 10 1979 1Y To Be Filed in Duplicate - Prescribed By State Board of Tao Commissioners `` CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 79 SEE BACK FOR FILING INSTRUCTIONS '(We) iia-C. / 1- f� C. , ( certify that on the 1st day of March, 19 7? (We) occupied as our pri ipal 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 in est in the taxpayer Property Description in County Township Taxing District—reify, Town, Township): [fir Parcel Number or legal d scription shown on tax statement: - qt . dui % /d'-/- 9 G er, ,24—ackz If buying on contract: Owners name free 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 ., ®h by certify the above statement is e, correct and complete. . L" 0,--a—nit...ei-J ai b )ha_......c,a u. Z•✓ 47 (o y /S. store Street Address I CI*. 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 n • "t Value Valuation Valuation Land not exce`e ing111 (one) acrmedl.m tely surrounding r`gsidential improvements (1) _ r6-6-0 /70 /70 Other Land (2) /c5 /40 S/6 US/�������� O;.�v is 1979 Total Land (3) / 4360 79 7 �ffff��' r Residential Impro me (4) 1 570 Dwelling _ � • r ' Garage (5) —0 _ _ AUDITOR Total (6) cl I/ 7 0 94970 O�\ at Other Improvements (7) ..2.240 �J ��jj�jjj la Improvements - Line (6) plus (7) equals (8) (8) �/ / 0 / 7 0 © I eby certify the ab ee is corre t. and complete. 02 MO .6_ // - 79 Signature or Assessor Dare ' - TION BY AUDITOR - Approved: ■`C 9- k - - ae Date: 6---- 1 S- -7 f ,• sun fORM!,!M,CINNI nn,a[Erl FORM 11-IA APPRIWEO BY STATE a35R1 OF"remsli,!tn. P E I_V[R I B F D BY THE DIPARTNIE4TOFLOCAl novaxmirr FINACEw 6I.1-1241 Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and tarried couples are limited to one homestead standard deduction.As the receipt of this deduction becomes more beneficial,there is more incentiw than eser for homestead fraud.homestead fraud causes higher rat bills for all:therefore. • HEA 1344-2009 requires aspa)crs oho receive the homestead standard deduction to verify that they arc eligible to recehe the benefit and to provide additional identifyine information necessal'to allow county government to better monitor homestead filint, This information will he kept confidential and can only be accessed by authorired county officials.'the Uepannsem of Local Government Finance will use this infornation to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address _ Coomer, Joe L/ Bette C \ K of 64', - ncicco IN .7649 1060 Joe UBette C Coomer 4619 N 575 E State Parcel Number Leal Description Francisco IN 47649-9226 Itlttlltrtltlltrrlttlltittltltttrlrltrlllrll DM III 26-06-18-300-000.115-017 C-1 009-00115-00 PT SW 18-1-968.25 AC PART 2:TAXPAYER INFORMATION Owner 1 First Middle Last � OQ ., .2.-_ a 0 6 h'1 �t>✓ —�c Address(rmmber and scat,city,state,and ZIP code) El Same:.s ptopcnv address - - - LP Li9 Al SZS E ■r-ay., l5��A) 7 4q Spouts l/ First Middle 0 Last CT°1 ell, �. 0 D G l vle.� Mailing��AAdddd''drr`erss(/ umber and street,city,sate,and ZIP code) 0 Same ass(property address 7' b / 9 N 57 s V VY-e_,V,_C ( c�� - I-I L�2S PART 3:CERTIFICATION Each undersi fined certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is eliuible 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 �r /a Uate —\ PART 4: ADDITIONAL INFORMATION S