HomeMy WebLinkAboutHomestead_Davidson (2) FOPJA HC 10 1979 s■— ix To Be Filed in Duplicate
Prescribed By State Board of Tax Commissioners —
CLAIM •FOR HOMESTEAD PROPERTY TAX CREDIT FOR- YEAR 19 79
SEE BACK FOR FILING INSTRUCTIONS
®r..i 4�
(We) / ' certify that on the 1st day of
,viarch, 19_2, I, We)/.ccupied as our 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 intt est in the taxpayer
Property Description in J_A_erct-0-7 ) County _ % Township
Taxing District (City, Town, Township): Cf�'�f1'�
Parcel Number or legal description shown on tax statement:
et . 4-o id /- /o /0-out/
If buying on contract: Owners name Pee 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 statemen s true, correct and complete. •
ati: a • weeye;.-2, SaLa..., v7ev_D
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.
T qM , - FOR ASSESSOR'S USE ONLY -
FED I I True Cash Assessed Homestead
Value Valuation Valuation
Land not exceeding 1 (one) acrelii91`Yniiat39t79
surrounding residential impro ments (1) So-o /70 /70
Other Land (2) — 0— — 0—
/://(4/24....
Total Land AU (3) � /70
/81166
Residential Improvements Dwelling (4 -
Garte (5) — D — � Xj/ ,,°.;r 5/70���_`S/7
o�„_ri- •#/
-
Total i0g&)0
. wi ji
Other Improvements sop G`. • _..et
T '-' Improvements - Line (6) plus (7) equals (8) / L ti(V o 'ad .j�
I oy certify the ab e is true. correc and complete. 7 ItO
�4, J e_ //— 79
Signature of Assessor Date
- CTIO BY AUDITOR -
Approved: -/` 4►li ' _- r . ' r Date: C 7 `�
•
•
at■IE FORM!3Hlll'/YNI TREASURER FORM YIA
Amoy ED BY cisaL a *PDOE■YYALATI`nv PVYRIBM BY TIE DEFARTE`rt OF VEAL w vrrVNEAT MANCE 101-I.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 ner for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receue the
benefit and to provide additional identifyin_ informaon nemnry to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Dqunnien 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 Property Address
Davidson, Jay M/Julia M
RI Box 115
I lazlcton IN 47640
1774
Jay M Davidson
9358 N Salem Lane State Parcel Number Legal Description
Hazleton IN 47640-9314
�t�t t��ttt�t��ttt�tt���ttt�t�trtt��tt tt��r�rt�t�r�t�tt�t�t�tt� 26-02-47-003-000.137-017 009-00137-00 PT LOC 3 1-10 1 AC
PART 2: TAXPAYER INFORMATION
Owner I First Middle 15_ Last
F)cg y �r J4 v1 o n
®tg Address(number and street,eitf,state:and ZIP code) - —---'— ®-Sutmt+u propcity
—
eP 58 dV, L,r/
•
Spouse First �j ///�Miiddle Last
/
Mailing Address(Number and street,city,stale.and"LIP code) I Y I Same as property address
bD
"et fro tt 5 R. U t 1�J
•
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 c...) Date
PART 4:ADDITfONAL INFORMATION