Homestead_Ice (3) FOAM HC 10 1979 :.:, To Be Filed in Duplicate
Prescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 77
SEE BACK FOR FILING INSTRUCTIONS
( ` li � 2 Qom.„ .
4.(We) certify that on the 1st day of
vtarch, 19 77 I, (We) 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 interest in the taxpayer C���_ / /� )
Property Description in _ County U -4— y"er'— Township
Taxing District (City, Town, Township): (/ .
Parcel Number or legal oliscription shown on tax statement:
/YIb /24 /- /0 077. 335
If buying on contract: Owners name flee 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 statement is true, correct and complete.
/ / s - / / I /
'Signature / Street Address ' Clty. State and rip 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 OtheruLatnd exceeding resdential improvement„FILED (1) <317� / /10 �0
Total Land JUN 5 1979 (3) 41 a- 90 / V30
,9/Residential Improvements Dwellin (4) Z6ao
(5) — 0 —
AUDITOR (6) S7(0 2 0 1//O � /
Total
Other Improvements . (7) — 0— — 0 — ��OODOOO�
Tc"-1 _Improvements - Line (6) plus (7) equals (8) (8) ne, a 0 _2.6 7B
I Croy certify the ab ye is true. corr t. and complete. f4//0
Signature of Aaseswr UU Daze
- ACTION BY AUDITOR -
Approved: g- 79 < .t�-e- •Date: 6 -.5 - 79
STATE FORM S'A,R'/set TREASURER FORM T31A
,APPROVED BY SLATE BOIROOF MTuNLS.2074 ParrRIBm BY THE DEPARTMENT(4LOCAL GOVERNMENT FIANCE IC 41.1'[al
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple are limited 1a one homestead standard deduction.As the receipt of this deduction becomes
Al' more beneficial.there is more incentive than ever for homestead fraud Homestead fraud causes higher lax bills for all;therefore.
� HEA 1344-3009 require taxpayers who remise the homestead standard deduction to verify that they are eligible to receive the
' benefit and to provide additional identifrine information necessary to allow county government to better monitor homestead
filin''.This information will he kept confidential and on 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
_ Ice, Michael/Ann
8839 N Nixon Rd
I lazleton IN 47640
894
Michael/Ann Ice
8839 N Nixon Rd State Parcel Number Legal Description
Hazleton IN 47640-9320
26-02-57-126-000.357-017 009-00357-00 PT MD 126 1-10 27.50 AC
r n nr It II nr I n III nr I r I r n I I car't III I I t I t I Our IIt I
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
fi?l (bael/ d J0_09
es -e. e' .
g Address(number and street,sir,stile,andZtZIP code)_.- Fla" — - /— — - me m propc,ty midi cu,,
K39 N A/ `lee n /LOQL, /-fez Zie7�dn rM A/7m AID — —
Spouse First Middle Last
Ana Zee_
Mailing Address(Number and street,city,state,and ZIP code) aSan(e as property address
SsK3q Al All ice n cRoa_d, zlefo-n , zN 47/c0lo
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is tole and correct and that he or she is eligible to
receive the homestead standard deduc on on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable f r ba ' taxes and substantial financial penalties.
Owner I Signs Date
PART 4:ADDITIONAL INFORMATION