Homestead_Barnett FORM HC 10 1979 To Be Filed in Duplicate
Prescribed By State Board al Tax Commissioners
. CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT. YEAR 19 79
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SEE BACK FOR FILING INSTRUCTIONS -
O(We) Xo /RL
n >j ../ ,9"1/EA"✓ 2i9Rn/err certify that on the 1st day of
arch, 19 yy I, (We) occupied as our principal place of residence the following described real property for
which a�Hoomestead Property Tax Credit is hereby being claimed:
I, (We) owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer , II .
. Property Description in a,6 sot./ County LUNiTE A tJ6,C Township
Taxing District (City, Town, Township): _.__ /4/62_LeTod
Parcel Number or legal description shown on tax statement:
-
OLD /0&m, G Pr/7 s
If buying on contract: Owners name (tee simple °aner)
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.
—� .�w �a
'S' ure Street Address City. State and Zip C°de
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 3o0
surf r ycide�ie� i�tp�vements (1) .00 ao-o, to-
Othe an tit L (2) — o — — o — /DOOOOOO/
Total Land (3) ‘ o o R--err 77
ResidentiMAYnp5ovel9lrt9s (4) $$rc ���W7 ////��
Dwelling yg/O //iii// � %/�%
�j Garage (5) �7 warm/ .0-/- kn.: ;4°lla�
et //{ti (6) -0- 1-- —°— At 1-e .
AUDITOR Total
Other Improvements (7) — o— —o -
IrImprovements - Line (6) plus (7) equals (8) (8) -gar
by certify certify the alive is true. correct. and complete. {` e
IS e /L tea/ S -+L- 79
f Assessor / Date
ACTION BY AUDITOR -
/� S= s'. 7 9
Approved: / Date: ,Th
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STATE FORM'3M 1R2(,-Ft TREASURER FORM 31A
VIMO:ED BY MATE BOARD OFamR¢TS!vr PILLSOUBFP BY TIE DEPARneTCF LOCAL GOVERNMENT FINANCE IC 6-1.1-72-t1
• 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
0 FILED mom beneficial,there is more incentive wh than ever for homestead fraud.Homestead o fraud causes higher tag bills for all:therefore.
HEA 13444 2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to lecene the
benefit and to provide additional identifying information nee sary to allow county government to better monitor homestead
.filings.his information will he kept confidential and can only lx 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.
MA? 3 ZulU PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
)7 4& Barnett, Ronald M Jr/Billie Jean
GIBSON COUNTY AUDITOR 109 S Main
Hazleton IN 47640
228
Ronald M/Billie Jean Barnett Jr Jr.
109 S Main State Parcel Number Legal Description
Hazleton IN 47640-9013
liltt��ttt�t��ttt�tt���ttt�t�tt�� ��tt��t��tr t�r�t r�ttt�� 26-02-59-032-000.021-019 014-00021-00 OLD PLAN 6 PT/7 PT BLK 3
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- PART 2:TAXPAYER INFORMATION -
Owner I First Middle Last
o nit)AD /17 /3RRnErr JR-
iiig Address(nurnberaEid'sueer-city;state;and Zi'r code) - - -'- -zSame as propcfy adds-- — - - - - - — — —
Spouse First / Middle Last
-0/LL/E rig el Ai 319 2AiE rT
Mailing Address(Number and street,city,state,and ZIP code) In Same as property address
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
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