HomeMy WebLinkAboutHomestead_Thompson (2) 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 79
SEE BACK FOR FILING INSTRUCTIONS
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( (We) `-_ a -=•may _,/ i --� % / , ' ' certify that on the 1st day of
`search, 1979, I, (W-• occupied as ou/principal place of resifence the f. owing described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract ,
❑ have a beneficial inteyy��eest in the taxpayer
Property Description in ,/Z<__ • _ County 1��. Township
Taxing District (City, Town, Township): !/V/
Parcel Number or legal d scription shown on tax statement:
Q, "-pia-re /-/o J5?LC LJ
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
I hereby certify the above statement is true, correct and complete.
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l/ ig/lure / Street •.tress City. State ip Code x Y/t- 99y
' Individual either owns or is buying under a contract that provides he is to pay the prop!ty taxes
on the residence, or has a beneficial interest in the taxpayer.
re-
- FOR ASSESSOR'S USE ONLY -
True Cash Assessed Homestead
, Value Valuation Valuation
Land not exceeding 1 (one) acre immediately
surrounding residential improvements (1) 5-� / O
Other Land 3.• (2) (0 3.5"0 4/0100<l ^-1_yi?/
Total Land (3) LogrO __� -9
Residential Improvements d 19'19 Dwelling (4) ,14-s0-
Garage (5) — 0—
•�otal (6) tiC S-0 - r.•
Other Improvements AUDITOR (7) /4/ 510 1,0
To' ' Improvements - Line (6) plus (7) equals (8) (8) ,S9 9 0 - _ ern
I Irby certify the abo is true. correc and complete. a860
a L cc, m /� - 7y
Signature of Assessor Dare
�Gy� -7D�/ ACTION BY AUDITOR - r �y
-Approved: `4, • 9, �/J�%a ...s/ Date: f0 - �f - / 9
STATE FORM:3,1.0CI•NI MarasutDA TORN TS-IA
AP/RI-WED BYSTUf.BOOM*MRU%TS.9n PREXAmm BY nlE DrPARlWYTOF LOCAL oOYERVMrra FINANCE IC 4-1.1-124
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 nee for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• ILEA I344-2069 requires taxpayer,. who'revive the homestead standard deduction to verify that they are eligible to recent the
benefit and to provide additional idennfyme information necesmry to allow county government to better monitor homestead
filing.This infmmahon will be kept confidential and can only be accessed by authorised county officials.The Ikpannwnl of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
p1 Taxpayer Name Property Address
FI I g D Thompson, Delores J 148 33 N
Patoka IN 47666
1892 APR 6 Zulu
Delores J Thompson y�
4833 N Shiloh `,[ State Parcel Number Legal Description
Patoka IN 47666 GIBSON COUNTY AUDITOR
26-05-57-088-000.791-017 009-00791-00 PT MD 88 1-10 35 AC
D-12 C-1
PART 2:TAXPAYER INFORMATION
Owne yA a First
41 Middle Last
yn
g Address(number and street,city,stare,and ZIP. - -- - Same toperty uddrcas - - — - -
Lis 33 74 R�Q F J - lo,6‘
�
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sae
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 home . e rd deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he .r shevnay be ia. - for back taxes and substantial financial penalties.
a Si Date
SPigir • G044,6 lc
Spouse-1, t Or Date Telephone ( l
PART 4: ADDITIONAL INFORMATION
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