Homestead_Smith (2) FORM HC 10 1979 :.-e-- To Be Filed in Duplicate
Prescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 79
SEE BACK FOR FILING INSTRUCTIONS
(We) '1-A - I :a. A. - l 4 - certify that on the 1st day of
arch, 19 ' , I, (We)Occupied as our principal p fce of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We)B,owned
❑ are buying under contract
❑ have a beneficial inter st in the taxpayer
Property Description in _ County A 1 —! %1 ' Township
Taxing District (City, Town, Township):
Parcel Number or legal scription shown on tax statement:
I\ 6.2- it % I c u 7¢ .1/- I - 9 a, 7/ace,t.-
If buying on contract: Owners name (lee 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 •
reby certify the above statement is tr e, correct and complete. //n .(71714/47
/0 Ki-ze:; : -lure 71 Street Address it y, 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 e) acre med ly
surrounding residential prgveme(!ts (1) �4 ° /`�0 /
Other Land �, �a (2) /0 ® 9'
Total Land JUN 2 7 197. 9 (3) _580 s 1 /D
Residential Improvements Dwelling (4) /°2 a c$0 2270 a, 424....a..0
(6)rage (5) Q 2 o %%%%%%%/ %%�%%%O•
____
Other Improvements `' AUDlTDRTotal (7) cad / So -76-71-0•> r jj��jj�j��
— Toil Improvements - Line (6) plus (7) equals (8) (8) .33 Y .56 I.., / .S&-
I Miry certify the of ove is true. cor ct. and complete. - A.5-930
du_i, te.,t . , • e5=//— 77
Signature of Assessor / ' Date
/ACTION BY AUDITOR -
i7g . —�- -
Approved: 1 • Date: 4
STATE FORM•! •in/;441 TREASUIIA FORM TS-1A
.APPROVED at CI UL MSRO M✓T'RLNTA:Ms PRFAAIBW BY THE BFPARTRYI OFtOtAL GOVERNMENT MTANCE MH.1-_tl
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than net for homestead fraud.Homestead fraud causes higher tax bills for all therefore.
• HEA 1344-2019 requires taxpayers who receive the homestead standard deduction to verily that they am eligible to recene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This intbrnatinn will be kept confidential and can only he accessed by authorized county officials.The Depannlent of
Local Government Finance will tine this information to create tools that will help county officials eliminate homestead fraud.
. ,'PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Smith, Jerry D/Connie J
m}y
768 �� Francisco IN 476649p �,I
O/oe. 3�'v.
Jerry D/Connie J Smith
7818 E 350 N State Parcel Number Legal Description
Francisco IN 47649-9265
Irirrllrrrltllrtrlrrlltlrtlrltrrrirlrllrrtitlrtrr���rt1r1r1rl1 C-t
26-06-21-300-000.724-017 009-00724-00 PT SE SW 21-1-9 2.78 AC
/
7...---T PART 2:TAXPAYER INFORMATION
Owner I First Middle // Last
_ 2 D i;7.1% .
te.Addicss lmm�ber and saect city.smtE:arid ZIP code)-..- - .I, --' (Sarno asplopcnr•addres •__ _. .--s Irrf u'�
78/8 F 3S0 N JAANe/Sco, fl" e--/2'9
Spouse First „--- A Middle Last
Mailing Address(Number and street,city,state,and ZIP code) I—I Same as property address
gor/57 £ . 3S_ o A/ .__art ileiseo 1 iYtL�� X SZ 9
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
r
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
S net I Signature Date
PART 4: ADDITIONAL INFORMATION
•