Homestead_Ice (4) y •
4 HC 10 1979 I" • To Ee Filed in Duplicate
4. ;cribed.By State Board of Tax Comnissioners ,- -. ,
CLAIM FOR HCMESTEAD PROPERTY TAX CREDIT FOR YEAR alit
SEE BACK FOR FILING INSTRUCTIONS
r 'I�� U (r �_ god_ certify that on the 1st day of
I>1,19 0,, I, (We) occupied as our principal place of residence the following described real
'.ifierty for which a Homestead Property Tax Credit is hereby being claimed:
(We) R caned
Dare buying under contract
0 have a beneficial interest in the taxpayer . . •
operty Description in llCcdd . County Township
xing. District (City, Town, Township) : 710 eto-!(i.c÷
rcel number I or legal description shown on tax statement:
I 64-4 .a. 71-cLits. 7/8/9/i o pt /$ /4,
buying on contract: Owners name (fee simple owner) '-�b b
Contract reoorded. in Recorder's Office - Record Pb. Page .
any portion of the residential structure or the land, not exceeding one (1) acre that
mediately surrounds that structure is used to produce inane, describe the-use and portion of
:e property utilized to produce income
r .y other counties in which individual owns or is buying real property: • County unship•
I ,y certi - the above statement is true, correc/t� and complete. •
tee -- *',\ - - A . . AL/ i / /d45 ./(„... . ..,. _ „I% o
-*Signature • Street Address i 'ty, State and Zip Code
*Individual either awns or is buying uner a' contract that provides he is• to pay the
property. taxes on the residence, or has a-beneficial interest in the taxpayer.
— Ge ASSESSOR'S USE ONLY -
• F I L _
�` Time Cash .
Assessed Homestead
Value - Valuation . Valuation
ird not exceed ng 1 (one) acre i.mnediately i
:rrounling residential' impfpvi n'k9984 . (1) / $¢ GO° .aa
:her Land (2)
_. ---9.410 /�-/� C 0��Goo /
tal Land y-c O. (3) {� / ‘ Sv
sidentiaT Ingrovenrents r UDfl R llinq (4) `714-1-71:0 /
Garage (5) — /
• Total (6) 4490 /'DSO /$80—
her Improvements (7) /
'; Improvements - Line (6) plus (7) equals (8) (8) q y `f O / `/ So /
?--• certify the above is true, correct, and complete:
.q ature of Assessor Date ,
- ACTION BY AUDITOR = -
•
„ • %ME Ir*St i!.ile/'-Mt T L5&IUA FORM 3-tA
.APPROVEDBY'tAIL now°Of AMM ARVIN._Y•y PREATIBtD BY fit[DEPARTMENT OF LDCAt CATPLNMFAT re:st-r IC VI.I-u-sI
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 becomes
dais
lir more beneficial.there is more incentive than ester for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
ILEA 1347-7007 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to reecho the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.this information will he kept confidential and can only he accessed by authorized county officials.The Department of
Local Government Finance will the this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
Ice, Ronald A/Scarlet R
- Rrlt3ox 1180
Hazleton IN 47640
11
Ronald A/Scarlet R Ice
10797 N 500 E State Parcel Number Legal Description
Hazleton IN 47640-9309
26-02-47-002-000.359-017 009-00359-00 BUENA vISTA
It Itr IItllltlltttlttllltttltltl 1111111141111111111111111111 7/8/9/10PT/15/16/17/18
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PART 2: TAXPAI'ER INFORMATION
Owner I First Middle Last
-_- g Address(number and street,city,state,and ZIP code) - - —
1h797T(Soo 8 /4a.2.ttIzv, s„ N'17&MO
Spouse First Middle Last
.SC' rc14 CR / 02
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as propene address
/0 74 7 N Soo t ge21€-Tavt , lA) r{763Vo
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
unla Ily,he or she may be liable for back taxes and substantial financial penalties.
er 1 ignatme Date rs O I�
PAR T 4: ADDITIONAL INFORMATION
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