Homestead_BeckermanPeuubed S; Stale Board at la. 4imnussmneis OF '
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19�Q`J" ,./
SEE BACK FOR FILING INSTRUCTIONS L' 000 -j 7 . 00
0 (We) t`a ��r I l �.1��1Y1 -4 certify that on the 1st day of
3rch, 19 I, (We) occupied as our principal place of residence the following 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 �inp the taxpayer '
Property Description in / County 1 Township
Taxing District (City, Town, Township):
Parcel Number or legal description shown on tax. statement:
If buying on contract: Owners
.hQ� a 7,la� %2430
(lee simple owner)
Contract recorded in Recorders Office - Record No. I Page SI019
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:
'hereby certify the above statement is true, correct and complete:
County Township
ignatun, Street Address Cidii 5,ai an L
Individual either owns or is buying under'a contract that provides he is to pay the p Iva �fe
on the residence, or has a beneficial interest in the taxpayer. J"" 1�9
' 'FOR ASSESSOR'S USE ONLY -' d
AUDITOR
Land not exceeding 1- (one) acre immediately
surrounding residential improvements
Other Land
Total Land
Residential Improvements Dwelling
Garage
Total
i
Other .Improvements .
To�mprovements - Line (6). plus (7), equals (8)
I �y certify the above is true, correct, and complete.
Signature oI Aslessor
True Cash
Value . .
(1)I
(2)
(3)
(4)
(s)
(6)'
Assessed Homestead
Valuafinn Vnhiatinn
M
(7) /✓%1 7,00
(g) L/ -3 O
- ACTION BY AUDITOR -
Dare
Date: ` �o
y2 3
•• ' 515Th rORM'a tr.:ts-nt TREASUAIR FORM a-iA
APPROVED DT[ts1L KAMM:A`tt,N'Tl!uw PIUYAlnmor net DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC 6-1.1-22-8.1
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 net fur homestead fraud.homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2019 requires taxpayers who receise the homestead standad deduction m verily that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county go'ermnent to better monitor homestead
filings:.this information will he kept confidential and can only be accessed by authorized county officials.The Depanmrnt 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
Beckerman, Ken A/Sharon S
304 Logan AVE
Hazleton IN 47640
79
Ken A Beckerman
304 Logan Ave State Parcel Number Legal Description
Hazleton IN 47640-8820
t IIIIIIIIIIIIi1 1�II���ntIIIIIIIIInt�t���n.IIuu�.IItuI� 26-02-29-200-000.0 7-019 014-00037-00 E ENLG 27 PT/28/29/30
(PART 2:TAXPAYER INFORMATION -
Owner I First Middle i Last
Ice IA i id - eel 4 illav) —
TZAddress(number and amxt,city,state,midZlP code) —)'— - —,�A- - "' " - -' Same as property address - _-- _ _ —
vU �� —O Can q�,>•Q `�/(�.z ►'1 \ O�l
-
Spouse First Middle n Last
StLcroil S be Ct,J2 (nil 4 ✓1
Mailing Address(Number and street,city,state.and ZIP code) • Same as property address
YJ e Q s �/,k at k ore--9
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 Si tore Date
PART 4: ADDITIONAL INFORMATION
0