HomeMy WebLinkAboutHomestead_Hyneman (2) FORM HC 10 1979 To Be Filed in 0(plicate
Prescribed By State Board of Tax Commissioners ,
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 77.
n
SEE BACK FOR FILING INSTRUCTIONS
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Sd d(We) • e" 6-IN ertify that on the 1st day of
arch, 19 I, (We) occupied as our principal lace of res. ence the following described real property for
which a�H/omestead Property Tax Credit is hereby being claimed:
I, (We) 18,owned
/❑ are buying under contract
❑ have a beneficial int est in the taxpayer q •
Property Description in County --/N _Township •
Taxing District (City, Town, Township): i Y
Parcel Number or legal de cription shown on tax statement:
OS . jet. /a.s /— /0 //a-chat-al
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
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alikhereby certify the above statement is true, correct and complete. •
/ 'Signature j Street now Cr(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 improvements (1) /70 / 0
Other Land .` (2) 470 ,Lc-6o'pa
Total Land F �- (3) /97O a— D
Residential Improvements Dwelling (4) `�`'.2-8o
tt !t.1 , : Garage (5) --0
— — Total • (6) 4LA 8 0 �p?4Y4 is �/
`-`' :, ,e,-,cS-1-' (7) /070 3sos/D�������
Other Improvements
T Improvements - Lin (6) plus (7)AWQia('sP(8) (8) S'3 ag0 /44-6-
1Irby certify above is trub correct. and complete. ..1,5--TQ
Signature ut Assessor Date
ACTION BY AUDITOR -
Approved: /n J ,t'�A6cc)
Date: 40 ' 9-77
SLATE[ORN s3 4TR!Wt 'MEASURER TUft 73-IA
• APPROVED BY STATE BOARDOE ACCOUNTS.!ON PRFAAmm BY Pit DEPARTMENT OF LOGALGM'RNMINT FINANCE M11-I.1-/24.1
Gibson County Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
PRINCETON IN 47670 Individuals and married couples are limited to one homestead ssandard deduction.As the receipt of this dedution!MUMs
more beneficial,there is more incentive than ever 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 am eligible to teethe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead*
tiling-This information will be kept conlidemial and can only be accessed by authorized county officials.The Department 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
Hyneman, Charles B
RI Box 103
Patoka IN 47666
1997
Charles B Hyneman
5167E 590 N State Parcel Number Legal Description
- PATOfCAIN-47666-9129 -- - -- — - -- - - -- - - --- - ----- --- - -- ---
Itlttlltntltlltttlltrtllttltl 26-05-47-125-000.346-017 00346-00 PTLOC 125 1-10 11 AC
trrttlirtltlltltrtllttltt tlltttll
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
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6/ 6rtos rtip5 / y11e.,Vn6 )'1
g Address(number and strett,city,state,end Mir-ode).- amt as property a.dr s
5/67& 590N P41-0 k4 Thee '76g' Prol Miley!/adc�less»t2 As
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Ocher(please spcify in Part 4 below)
sax
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\Signa `�"`t '1! Date
, to 3 Spouse Signature Date Telephone -
PART 4:ADDITIONAL INFORMATION