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Homestead_Richeson 'rescribed-By State Board of Tax Commissioners CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19n i... • SEE BACK FOR FILING INSTRUCTIONS I, \-01e) ° " '_i v_ `�t� °i ��d " certify that on the 1st day of -ph, 19 , I, (toe) occupied as our principal place of residence the following described real erty for which a Homestead Property Tax Credit is hereby being claimed: I, (Ice) a—owned pare buying under contract have a beneficial int st in the taxpayer . Property Description in eY County _ A.2 /e,--2-4---. ` `` Township Taxing District (City, Tam, Township) : 2 d‘4.70 . Parcel number for legal description shown on tax statement: U / If buying on contract: Owners name (fee simple owner) , O ��� Contract recorded in Recorder's Office - Record No. Page If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that structure is used to produce incase, describe the use and portion of the property utilized to produce income Pny other counties in which individual owns or is buying real property: : - County Township "earthy certify the above stategrent is true, correct and Clete. • 40. /,c c.kC.,.,. /�,,.. *Signature - . Street Address City, State and Zip Code *Individual either awns or is buying caner 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 exceeding 1 (one) acre immediately surrounding residential improvements (1) .moo / 7 o / �j� o // Other Land (2) / o . J -s _ '3 _ Total Land (3) 6 c 0 'Z0 ° // �����0_� Residential Inproveimnts Dwelling (4) 2 �a�o / ����� Garage (5) — / Total (6) 0t s fl o FS q / o FS S1/ o Other Improvements (7) P'�� S 2-° �� ' To .! Improvements - Line (6) plus (7) equals (8) (8) A a o Dg./0 ��� I hereby certify the above is true, correct, and cc plete. 4 • /3 9. ,&/, Signature of Asses Date - ACTION BY AUDITOR - - a....,.._;;od. Date: SIATE FORM!TtC'4Ix/f+Yr TREASUarA FORM 11A • .ArrRINLD BY ARE B(HRD OF∎CCOL•TS 9n PLEYR®m By Tilt DEPARTMENT OF LOCAE tiCNEItTaKt FINANCE c I.It-EI Gibson County Auditor 11 N Main IMIPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 101 N PRINCETON IN 47670 Individual and married couples are limited to one homestead Aandard deduction.As the receipt of this deduction becomes more beneficial.there is more incentive than ever for homestead fraud Homestead fraud causes higher tan 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 identifyine information necessary to allow county goanment to better monitor homestead filings.This information will be kept confidential and©n only he 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 I:PROPERTY INFORMATION Taxpayer Name Property Address Richeson, Walter W/Sharon M 613 S Old Patoka Rd Patoka IN 47666 31 Walter W/Sharon M Richeson 613 S Old Patoka Rd State Parcel Number Le!a1 Description Patoka IN 47666-9002 Il�rt��Itt�t��ttt�111111rr�r�tr��trt�� 26-04-25-302-000.564-020 PT SW PT NW PT SE 251111.317 tnrrr�r�I1111111lutlitn� 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 __ GvalLer I,tiJ1ittii rCWese0 4101g Address(number and street,city,state,and ZIP code) 1 A Same as property address _-- kg Sd 6/1-aa ke f la1' .T4/ V/7114( Spouse First Middle Last 5lc 0 far eN ic1 esal7 Mailing Address(Number and street.cipy state,and ZIP code) ,( � (y`{Same as property address 612 I .t c `,4r IaLO�P/-TA/ 1�?filj = 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