HomeMy WebLinkAboutHomestead_Pickett (2) CLAIM FOR MillEAD PROPERTY TAX CREDIT FOR YEAR 19= .
SEE•BACK FOR FILING INSTRUCTIONS . .4 .
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T ,� ). . Se 1 t �ALA Q • '°., -30 certify that on the 1st dpy c
T" >PL 11 described real
�:h, 19_, I, We) occupied as our principa place of residence the follorir:g
property for which a llorrestead Property Tax it is hereby being alauced: -
I, 6+e) O awned .
Dare buying under contract .
El have a beneficial p�iintere��st in the taxpayer
Property Description in `^ County k...i "...ksQ-A. Twmshi
Taxing District (City, Town, Township):
Parcel Lhrter 1 l 1 I . l or legal description shown on tax statement:
T SC-14 can-- r- I l j. S'U 0-c.
If buying on contract: Owners name (fee simple owner)
Contract recorded in Recorder's Office - Record No. Page
If any portion of the residential structure or the land, not &reeding one (1) acre that
tiately surrounds that structure is used to produce insane, describe the use and portion of
the property utilized to produce intone .
Any other counties in which individual owns or is buying real property: County Township
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Ohereby certify the above statement is true, correct and couplets. • •
*Signature :.
Street Address . . City, State and Zip Oodc
*Individual either owns or is buying user a contract that provides he is to pay.the
property taxes on the residence, or has a beneficial interest in.the taxpayer.
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. - FOR ASSESSOR'S USE ONLY -
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• True Cash. . "Assessed Ha:Estee:
Value Valuation . Valuatio:
Land not exceeding 1 (one) acre imned.iately •
(1) to CO 7v 7 •
surrounli g residential improvements a) —O_ 3 n ���/
Grier Land , (3) 6,00 c o��(�� f//0/0%O/z
Res ent;ai Improvements Dwel7.ing I (4) odor 90 7// //////// /// �/
Garage (5) " O
Total (6) a9aVD . 9750 . - 97$Z)
ether Improvements (7) 7-0 - - —s- O/�////////
To ' Tuprovarents - Line (6) plus (7) equals '(8) (8) a9?go 97 CC) /////!/// %1
I hereby certify the above is true, correct. and =pieta.
Date
IP"
Slgnanne. of Assessor
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- ACTION BY AUDITOR -
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Date:•
Approved:
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',WE PrR I LW*I0.:t.V'I IFIAS iLEU FOLM 11A
APPPm'ED BY VIOL IXMPDDF✓rolivra.!aw rtrYMED BY TIE DEPARMEYf OF LOCAL rovrVYMEAl matter K'6-I.I-E_4.1
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
lir more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tat bills for all;therefore.
HEA 1344-2009 requires taapa)ers who receive the homestead standard deduction to verify that they are eligible to recebe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.'Ibis information will he kepi conlidemial and can only be accessed by authorized county officials.The Detainment of
Local Government Finance aill use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Pickett, Paris B `/ef Cgi/ rj
Patoka IN 47666
648
Paris B Pickett
618 S Old Patoka Road
PATOKA IN 47666-9002 State Parcel Number Legal Description
o 26-04-25-400-000.562-020 PT SE 25 1 11 1.5905 AC HUDSON FARM
t o oL IL II u uL I I n I L I n I I uL I I ouL I L I of III o I t t III
EAST 2PTI5PT
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
a,..auig Address(number and street,city,state,and ZIP code) Same as property address - - - —
Spouse First Middle Last
Mailing Address(Number and sweet,city,state,and ZIP code) D Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
soy
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is tole 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
Spouse Signature Date Telephone
PART 4:ADDITIONAL INFORMATION