HomeMy WebLinkAboutHomestead_Brackin FORM HC 10 1979 To Be Filed in Duplicate
Prescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPE,4TY TAX CREDIT FOR YEAR 19 79
SEE BACK FOR FILING INSTRUCTIONS
lb(We) Jog .61 gL RR4)c,e.Al / /•, ', - -tc�_certify that on the 1st day of
olarch, 19_ I, (We) occupied as our principal place of reslidence 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 in the taxpayer - — -
Property Description in 62/85oAy ,// County bir/'TE " 'vete Township
Taxing District (City, Town, Township): //Aa.LereA✓ L',4,
Parcel Number or legal description shown on tax statement:
-0ieo.J,/s A7 1 bA/ 02 9 .E.6
If buying on contract: Owners name (fee simple owner) ,289 T -
Contract recorded in Recorders Office - Record No. Pages Pf
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. -
ere_ rg,a.,e_ J £-l�nn7 a /4 'ib r 5z7e o
gnature Street Address City. tate 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 surrounding sid ital mpro a ��lately (1) _900 /00 /00
Other Land tttttt��� (2) — -a,10
Total Land r1;,;1�: 1 ;0 979 (3) Soo /tea ?A ...........,.„„m„,.....„
1�.. Dwelling (4) /41 s/o 9 %jjjjj j/ �/%�%%//
Residential Improvements /
- . /D/O/O/�!
<IATE rots.tS'9 'S-PI ThFASURER FOAM:SAA
ArrRtWEt nT ST1TEBOKDOr MR%ArS.`rm PRLARIBWBY TUE UEPARIMEYtOFtocAl CKATANMFM ra:A:CEICFl.1-L-r-I
Gibson County Auditor 101 N Main IMPORTANT.NOTICE TO HOMESTEAD PROPERTY OWNERS
• PRINCETON IN 47670 Individuals and married couples are limited to ore 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.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be 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.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Brackin, Joe Earl/Betty Lucile
3rd ST
Hazleton IN 47640
44
Joe Earl/ Betty Lucile Brackin
P O Box 273 State Parcel Number Legal Description
Hazleton IN 47640-0273
Itltrllrtrltlltrtlttllltrt�� 11ttt1ttlltltttlttllrltrtll 26-02-59-032-000.058-019 014-00058-00 BR 1ST ADD 29 PT
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer. .
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
•long Address(number and street.city.state,and ZIP code) ❑ Same as properly address
4' DI 1Bu j a23 - Ao3 1d, 3 ,AX , Z.J !� /si; 97‘��
Spouse, First Middle ,Bie. Last
Mailing.Address(Nu ben and steel,city,state,and ZIP code) Same as property address
61: ;ooj[ -273 - s o3 eJ3k- . I / Z// 7‘ 41U
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 Signature Date
PART 4:ADDITIONAL INFORMATION
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