Homestead_PhillipsFORM FIC 10 1979
Piewrilied By Stele Board of Tax Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 -1 ✓
OC,,D. S- D6 -E'S SEE BACK FOR FILING INSTRUCTIONS ✓O1 g — c a 39 3 - 06
�(We) gaa4a 2 � � � C • bl;1✓S certify that on the 1st day of
March, 19� I, (We) occupied as n r principal place of residence th_ 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 v
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name llee simple
my
Township
or legal description shown on tax statement:
Contract recorded in Recorders Office - Record
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
ereby certify the above statement is true, correct and complete.
and
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
Value
Land not exceeding 1 (one) acre immediately
surrounding residential improvements (1)
Other Land (2)
Total Land (3)
Residential Improvements Dwelling (4)
Garage (5)
Total (6)
Other Improvements (7)
T Improvements - Line (6) plus (7) equals (8) (6)
-i ,._ 3by certify the above is true. correct, and complete.
Signature of Assessor
- ACTION BY AUDITOR -
APP
Assessed Homestead
Valuation Valuation
Date
Date:
'Nn FOnI Wlnrfd, DL1NREA FOAM 31A
n 111OVEO BY 5•1/41E MkPOO:MTYYMA 2Orm Pnf3R1BmaY THE DEPA0.n e.T OF LOCAL rAwEF.NMrlr FEANCE If 6-1.1-224.1
Gibson County Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
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 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 ran only he accessed by authorized county officials. DepaMrcnt 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 Propene Address
_ Phillips, Judith C
201 Main
Patoka IN 47666
602
Judith C Phillips
P 0 Box 289 State Parcel Number Legal Description
Patoka IN 47666-0289
26-04-25-102-000.393-020 015-00393-00 SMITHLAND DIV 5
11111111111illitillisilloill III I t i I I t I r I r Ir Ir I
X
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Jud ;�l-in U lene Phi ll ; ps
- hint mg Addtcss(humba end saint,—city,start,eno�c cj— --' - - - 0 Sane oa property wIdit s PO Box aS1 (aol//S: rbo ;fi) Palaka I IN 4q (o(a6
,
Spouse / First Middle Last
•
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last S digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Sate
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 eliuible 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
� io �o
Sp (r Signature Date Telephone
( )
Th PART 4: ADDITIONAL INFORMATION