HomeMy WebLinkAboutHomestead_Hyneman (5) FORM MC 10 1979
To & FiIW 1i7 wplicale
Prescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT. FOR YEAR 19 79 - -
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SEE BACK FOR FILING INSTRUCTIONS
9k• g certify that on the 1st day of
ivtarch, 19 I, (We) occupied as our principal c‘ residence t e following described real property for
which a Homestead Property Tax Credit is hereby being claimed: -
I, (We) t!<Yowned
❑ are buying under contract
❑ have a beneficial int rest in� payer
Property Description in County Township
Taxing District (City, Town, Township):
Parcel Number or legal description shown on tax statement:
Q . 7/10-70oo 44;7 /-/0
If buying on contract: Owners name (lee simple owner) . Vt, 75L
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 statement is true, correct and complete.
• ignature Street �� cis*. 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 eFdji nE ediately
surrounding resi entia improvements (1) 5-0-0 X70 /
Land MAY 181979 . (2) /Oa
Total Land
(3'-
.��/O7a'"O
.ResidentiaRr my/Kau DweI in Ira 757Q
AUDITOR j/o jj-Garage (5) —b—
Total � - •
Other Improvements f (7) fsi'�
TN ' Improvements - Line (6) plus (7) equals (8) 1 g`{-oo�"(1 t
[Why certify the ab e is true. corre and complete. 4e-v-0 744o
6- /1- 79
Signature of Assessor Date
TION BY AUDITOR -
Approved: I Ziil&I Date: 2P-6,-1 0, 79 72.
'lilt FORM !V^IR:I NMI 1RWAnLFA rORV}IA
ArrRwro By'lial&N D OE (TAL:a,.ay. IarftRInfll BY lllr OrPARf WT OF LOCAL GOVERNMENT FINANCE IC I.1-r4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individual and married couple.are limited to one homestead standard deduction.As the receipt of this deduction becomes
mote beneficial,there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
•`, HEA 1344--2009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to teethe the
f benefit and to provide additional identifyine information necessary.to allow county government to better monitor homestead
FIT ( filing..this information will he kept contidenial and can only he accessed by authorized county.max.'s The Department of
7 F7 I, Local Government Finance will use this information to create tools that will help Lou.- a 'alt eliminate home tiaud.
PART 1: PROPERTY INFORMATION
APR 2 2 1U111 Taxpayer Name Property Address
Hyneman, Peggy 645--
� sly
n T-eimeTa S-
GIBSON COUNTY AUBITOP Patoka IN 47666 /\I
969 Ql/
Peggy Jean Hyneman
5345 N SR 65 State Parcel Number Legal Description
PATOKA IN 47666
26-05-57-119-000.352-017 009-00352-00 PT MD 1191-10.945 AC
1 / C-1
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
ELY r�� 1 yAl t-m19-Al
•tg Address(number onditra city,state,anhZIP code) —'----- aSanse us property address-- — -- - —
4-2 VS /0 s R 5 PA T RA N c/244,
Spouse First Middle Last
ci eten:Se-J
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Diver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
scar
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 S artlrc Date
Spouse Signature Date Telephone
( )
PART 4:ADDITIONAL INFORMATION
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