Homestead_Berry (4)FORM HC 10 1979 To Be Filed in Duplicate
Rescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 199
®1e -m003y
SEE BACK FOR FILING INSTRUCTIONS
which a Homestead Property Tax
I, (We) ❑ owned
4 are buying under contract
❑ have a beneficial interest.in the tax
Property Description in
Taxing District .(ri�Town, Fewrrship):
Parcel Number
If buying on contract: Owners
certify that on the 1st day of
ing described real property for
Township
or legal description shown on tax statement:
Contract recorded in
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.
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 -
Land not exceeding 1 (ore) age irrLdiae D
surrounding residential improvements
Other Land JUN 7 1979
Total Land
Residential Improveme4,11 /%�Iling
AUDITOF43arage
Total
Other Improvements
Tr' Improvements - Line (6) plus (7) equals (8)
I0by certify the abovpi true. correct, and complete.
Approved
True Cash
Value
(1) -f9D
(2)
(3) 590-
(4)
(6) S D
(6)
(7)
(8) �
- ACTION BY AUDITOR -
Assessed
Homestead
Valuation
Valuation
e'l— 7-
Date
Date: —Z-- - Y
- STATErOLM!OMIR_(s-M1 TREASUILER FORM 75-IA
APPROVED BY AT■TE B&wRDOF MYYRI\at21,1 PLEYAIBED BY TIE DEPMTMETOF LOCAL rntleedDCT FR:AK'EM LI.1124I
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 ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore.
• HEA 1344-2009 requires tnpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit anti to provide additional identifyine information necessary to allow county or eminent to better monitor homestead
filings.This information will be Leer confidential and can only be accessed by authorized county officials.The Ikpannarnt of
Local Government Finance w ill we this information to create tools that will help county officials eliminate homestead Gaud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Berry, Michael R/Janice C
104[Mill
Patoka IN 47666
457
Michael nice C Berry
o Box State Parcel Number Lezal Description
Patoka IN 47666-0131
26-04-24-300-000.034-020 018-00034-00 FISHERS 1ST ENLG
t o II nt It II set II t II n II II n II stn II II use II II
/ 2PT/3PT
PART 2:TAXPAYER INFORMATION •
Owner I First Middle Last
el R , err -
ag.Address(numbeb mid street;city,state,and ZiP code) - - -- '---" _— - Same ry prupeny addr -- - --
P.05 307( ► 3i ) 044 E. (Y): \1 St. Rut la , ia 47L(6,
Spo Middle Last
r
Stripe (_ r errs
Mailing Address(Number and street,city,state,and ZIP code) El Same as property ad
',Of R a /0 2. / st
PART 3:CERTIFICATION
Eachht --;:.-7-1 - - Les,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
IIII