Homestead_Ford FORM HC 10 1979 To Be Filed in Duplicate
Prescribed By State Board of Tax Commissioners
cultism HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 77
SEE BACK FOR FILING INSTRUCTIONS
•(We) �o �r �d ZdC certify that on the 1st day of
arch, 19_77 I, ( ) occupied 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 inte est in the taxpayer .
Property Description in County� _Township
gn
Taxing District (City, Town, Township)• l�Va.-a- .1Z-cM- "J--"
Parcel Number or legal des(erription shown on tax statement: c,, ti
0± 2t d— G 4e /—/o / ,90
If buying on contract: Owners name (fee 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
,'iereby certify the above statement is true, correct and complete.
`( /C" 7 Er 7 Y// / 0 ({ 1 1�rw ,1/4 J t
fture r / Street Address f' �����l%/� dity. 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 immediately
surrounding residential r is (1) 5-0_19 / 0 /�����0 D Other Land (2) °` .' •� = !/,e...e��
Total Land (3) 6724179 jjjj77
Residential Improvements JUN 2'1 1979 Dwelling (4) //epa 2 D
� // �Gu2 .(,Garage (5) — 0 — ��������� �������
j�' Total (6) //e a 0 _ly a- '.
Other Improvements I/ AUDITOR (7) /0 110 3a_9 .��/7fff
Tr 'mprovenients - Line (6) plus (7) equals (8) (8) .Z. /390 -
I Wy certify th above is true. co ect. and complete.
/1 - 79
Signature of Assessor Date
TION BY AUDITOR -
/ // __
Approved: A � �.-=-. ' Date: to ,�7
STATE FORM"It IR`I'AN) TREASURER FORK—IA
.APPROVED BYET\TE nNHRO OF ACCOUNT,.`ur, PtLAAIBM mL DEPARTMENT OF LOCAL GOVERNMENT FDA\CE IC 41.l-U-t.l
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 become,
• more beneficial,there is more incentive than ner for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
ILEA 1344-2009 requires taxpayer.who receive the homestead standard deduction to eerily that they are eligible to teethe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
tiling.This information will he kept confidential and can only be accessed by authorized county ollicis.The DepannTent of
Local Government Finance%sill use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Ford, John/Barbara Revocable Trust
Hazleton IN 47640
2980
John R/Barbara Ford
2552 E SR 56 State Parcel Number Legal Description
. _Hazleton IN 47640_— _ . _ _ _ _ _ - _
26-02-57-066-000.230-017 009-00230-00 PT MD 661-10 81.90 AC
C-1
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
6-0ei Rd DKr 1OR
g.Address(number and%meet,city,..._..,and ZIP code) - ❑ Same as property address
1- 2— s'ik 5--6 /ii-/-, rTd (1 'f7GVa
Spouse First Middle' // Last
Bar Az a-4— J L+- h
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
— S7f9 #6.-2-/---h -27 —
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 1$ignawre Date
PART 4: ADDITIONAL INFORMATION
•