Homestead_Fears SLATE rORM!)!o'tR'r HMI TReASI1REa FOAM TS-IA
.APFRQ'ED BY STMT.aOVID Or ACCOUNTS.9n PUSCIUDn)BY fir DEPARTq_YT OF LOCAL GOVTRNMII.T FINANCE IC LI.1-224.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS '
PRINCETON IN 47670 Individuals and married couple.: are limited to one homestead grandam deduction.As the receipt of this deduction becomes
® more beneficial,there is more incentive than net for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the hotnestead standard deduction to verify that they are eligible to receve the
benefit and to provide additional identifying information necessary to allow county government to better monitor homesead
filings.'Ibis information will be kept confidential and on only be accessed by authorized county officials.The Depanmern of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART.I: PROPERTY INFORMATION
Taxpayer Name Property Address
Fears, Linda Life Est Etal
RII3ox 157
Hazleton IN 47640
39
6355 N Nixon Rd State Parcel Number Legal Description
HAZLETON IN 47640-9329
I I I I I I I I I I I ' I I I I I I I I I I _
26-05-12-100-000.188-017 009-0018&00 PT LOT 18 2 FR 121 10
1u err ut n nt tuu nr t t litt ern n 1.50 AC C-1 - ..
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
-
Spouse First Middle Last
• /i/1/ f't�fs
Mailing Address(Number and street.city,state,and ZIP code) Same as property address
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
PART 4: ADDITIONAL INFORMATION
FORM HC 10 1979 To P,Filed)--Duplicate
Prescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 79 _
is hereby being claimed:
4 (We) L�f owned
- • ❑ are buying under contract
❑ have a beneficial inter t in the taxpayer �Al
Property Description in � County /�f Township
Taxing District (City, Town, Township):
Parcel Number or legal scription shown on tax statement:
- az . der" /gab 4.2_/-/0 7So6t.
If buying on contract: Owners name /lee 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
dihereby certify the above statement is true, correct and complete.
'ii:•acute / � j" -)Z�4/ Street Address - / City. State and i0 �e
■
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) aCB-0 / 7 o /70 I E
�
Other Land r (2) 02.6-0 70 14E9-
Total Land 71 (3) 7.6- ,,,4D
Residential Improvenaep9 r U ia7g Dwelling (4) /O-o
y Garage (5) —O - �/
/ , Total (6) Ai/0-0 !�"1IS1 n—i
Other Improvemn � �G�C2it (7) ///—� ' H=�ro
Tr Improvements - Li e (6) V ITPRequals (8) (8) ' / [9-0
I y'rcertify the a e is true. corre . and complete.
Le -4_,4-) - _//- 9
Signature of Assessor - - Date
n - CTION BY AUDITOR -
Approved: /C .9 . A&,. .. Date: ' `30/S 77