HomeMy WebLinkAboutHomestead_Perry (2) FORM HC 10 1919 t - To Be Filed in Duplicate
Prescribed By State Board al Tax Commissioners
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CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 79'
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SEE :ACK FOR FILING INSTRUCTIONS
®(We) - /f' At ' #!�a—, certify that on the 1st day of
``��� arch, 19_77_, I, (We) .fcupied as'fur princip.'place of residen - the following described real property for
which a—/Homestead' Property•Tax Credit is hereby being claimed:
H -
I, (We) owned
❑ are buying under contract - .
❑ have a beneficial inter st in the taxpayer
Property Description in County Township
Taxing /Taxing District (City, Town, Township): J
Parcel Number or legal descrip on shown on tax statement:
Q. ." - `7f '/ -2/-/- 9 /o
If buying on contract: Owners name Ilee 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
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Any other counties in which individual owns or is buying real property: County Township
®hereby certify the above statement is true, correct and complete.
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IlJ. .' • ' ,' _ _ 14 ., / �..J/ ///_ -.i 1 Ai- �?.0 /17
' ignature Street Address City. State and Zip Cade
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) x-0-"0 /70 77 O
Other Land (2) /7 /0 SO
1 Total Land (3) 021/0 �/#tD
Residentia pr is em .r (4) .3/9, 0
. Garage (5) La O /%/�� //
Garage id
JJUN 5 1979 S
Total (6) 33 2 O
Other Improve ents (7) — O J
Titiii Impr ten - )4 equals (8) (8) .33..0 44/ 0
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I by certify e a ve isqrrrec . and complete. /.5tO
a c Lao—) _// — 79
Signature at Assessor Date to
Q ��- TION BY AUDITOR -
Approved: -/ J(9 L� _.,( 2,?ed� Date: G/S_ _ZY
• STATE rots!535W,Re/-I0I IRSASURLR RIM.IS-IA
.V?RO,T_n LW'CLUE 3O\RO OEM(01 nl(ton ?RLsCRa1FD LW Oil.tVARTVLI OY LOCAL COVLR'OtL',l L'NANC:IC n1.1"+.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS'
101 N.Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
• F PI 04 tp more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud caws,higher tas bills for all:therefor:.
h
HEA 1344-2009 requires taspayen who receive:he homestead standard deduction to verify that they am eligible to receive the
( benefit and to provide additional idenuf■im_ information necessary to allow county government to better monitor horreslead
filings.'Ibis information will be Leg confidential and can only be accessed by authorized county officials.The Depanmem of
' Local Government Finance will use this information to crate tools thai will help county officials eliminate homestead fraud.
APR 0 2203 PART 1:PROPERTY INFORMATION
Taxpayer Name Location aricar Perry,Jennifer
GIBSON COUNTY AUDITOR 8047 E 450 N
FRANCISCO IN 47649
1164
Jennifer Perry 111111 1 11111110 111 11M111_11:1111 Mill 1II111 1111
8047E 450N •
Francisco IN 47649-9244
"1.IliIIirlliltilI�t'IIlII"IIIIIlI'Ill"IIIIIII'II'lII"'I'IIII State Parcel Number Legal Description
26-06-21-200-000.590-017 PT NE 21-1-9 10 AC C-1
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
(r I First Middle Last
eJenhiier /-- PeI- I-y
Mailing Address(ntnnber and street.city,stare. nds IP code) �Ame as propcny address
RO 7 E , 41.5'6 Al A Aita,lci5CO / /N 47&99
_ Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) 0 Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
1 1 1 sole
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 Signam{ Date
noire,U CA' - 44,4cif
°
use Si ure
Date Telephone
PART 4:ADDITIONAL INFORMATION-