Homestead_Robling (4) FORM 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
•(We) Q�r-uy, 54-- 4, I e , certify that on the 1st day of
arch, 19_71., I, (W occupied as our principal place f residence the f wing 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
Property Description in County Township
Taxing District (City, Town, Township): (� 1
Parcel Number or legal descriptibil shown on tax statement:
Oz . 71E% ‘ -/ - s
If buying on contract: Owners name (fee simple owners y0. 6 0
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.
cc? Tat* FE R" k Al 7 Z??off'. :% y7G#a
nature f Street 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) X0-0 /10 0
Other Land (2) 5`0 j7(1W'
Total Land
F I L 1* (3) .520 - iiiiioi
Residential Improvements (4)2 y 1979 Dwelling 76-3 0
Garage (5) /03 O j O / %%//%/j/
Total (6) SS6 0 : - - ear
Other Improvements AUDITOR (7) d S0
TN Improvements - Line (6) plus (7) equals (8) (8) 90 60
I spin y certify the ve is true. corr t. and complete. #•tiD
Signature of Assessor Date
ACTION BY AUDITOR -
Approved: , r� A Date:
SIDE I OPAM:'Mlaa•wl TRLASVLER FORM 3IA
.A/PROVED BY SMR&WOOF Amasrs.yM PAISCIUBED BY TIE DEPMfl 4TCFLIXTt COVERYMEAr FP':sertc 14-r-AI
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
more beneficial,there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-20')requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reeei'e the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
lilInt>.This information will he kept confidential and can only be accessed by authorized roomy officials.The Depanmenl 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
Robling, Wayne Edward/Wilma J
Trust
R 1 Box 184
Hazleton IN 47640
1017 (CAL
Wayne Edward/Wilma J Robling ►t(J
7457 N SR 65 State Parcel Number Legal Description
Hazleton IN 47640
26-06-06-200-000.658-017 009-00658-00 PT NE 6-1-9 40.60 AC
_ PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Ay W d w Astei
l-�7�,(? bz1At G
wAddress(number and street-city,stare,And ZIP code) - [rte as property address-- -- .- -
C,qMe AS AboVC •
Spo �jpt'i First j2ifitifyw Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑Same as property address
74 s77„it Rd6.C" 11 a 71
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(axes and substantial financial penalties.
Owner I Signature Date
PART 4:ADDITIONAL INFORMATION