HomeMy WebLinkAboutHomestead_McGuyer FORM HC 10 1979 rat To Be Filed in Duplicate
Prescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19_19_ .
SEE BACK FOR FILING INSTRUCTIONS
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(We) ' i#- Lt N IN`C
certify that on the 1st day of
fila 19_ , I, (We) occupied as our principal place of residence t following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
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I, (We) ❑ owned
❑ are. buying under contract
❑ have a beneficial inter in the taxpayer ,
i
Property Description in County __ - Township
Taxing District (City, Town, Township):
Parcel Number C147 or legal escription shown on tax statement:
get 2ni6- //Vet- //.5" /-/o
If buying on contract: Owners name (tee simple owner) 2•�
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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lehereby certify the above statement is true, correct and complete.
I ca 0 I
IS /.-. I /iL/i4 /' � _ '. ■ .♦a./L. _ < —4e■ —Li_ r /
'S•nature tit Address ' City. 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) .5-0_"0 /70 / 0
Other Land v 1 I E (2) /90 — / ���'
Total Land (3) 67 '2'Sa,
Residential Improvements �r.� 1�1a9elling (4) .1720 /O
, / �j�77J' S �/
Other Improvements
al r / (7) `T O/0 D ��
AUDITOR „/
Te'-' Improvements - Line (6) plus ) equals (8) (8) 4O/0 1icL 9// ���/�7��
I •by certify the ove is true: cor ct. and complete.
) 6=//- 77
Signature of Assessor Date
/� VACTION BY AUDITOR - / /
Approved: /' - Q. \ --GC-?�.[/u Date: Lam — b " 2 92
STATE FORM 53569(RJ8-09) TREASURER FORM T5-1A1
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC-I.1-22-8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
deduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
`auses higher tax bills for all; therefore, HEA 1344-2099 requires taxpayers who receive the homestead
standard deduction to verify that they are eligible to receive the benefit and to provide additional identifying
information necessary to allow county government to better monitor homestead filings. This information
will be kept confidential 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.
PA•Ti: PROPER l'INFORMATION •
Taxpayer Name Property Address State Parcel Number Leal Description:
Thurman W Rita K 7903 N 450 E 26-02-57-114-000.530-017 009-00530-00 PT MD 114 1-10 5.00
McGuyer Hazleton IN 47640 AC C-1
Complete and return to:
GIBSON COUNTY AUDITOR, 101 N MAUI PRINCETON IN 47670
• - . PART 2:TAXPAYER INFORMATION ,
Owner I First Middle Last
Wig V C.7
Mang Address(number and street city.state and ZIP code) I Same as Property address
Matting Address(number and street,city,state and ZIP code) Sarre as property address
Social Seauity Number(last 5 digits) divers License State ID Number(last 5 diglts) Stme Other(please specify in Part 4 below)
-_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 Signature �,�,,,�,,, Date -—�
spouse - tore Date Telephone
- • PART 4:ADDITIONAL INFORMATION -