Homestead_Stevens (2)FORM HC 10 1979
Prescrioed By State Board of ias Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 197
SEE BACK FOR FILING INSTRUCTIONS Qt$. 063Sq- G O
;40 (We) - �„J � -o& 94 b a-rn��n.7F certify that on the 1st day of
march, 19 I, (We) occupied as o principal place of residen a 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 ink Cre� J e a— County Q�J Township
Taxing District (Gily-Town, TeALR&14lt).
Parcel Number or legal description shown on tax statement:
� . , -7'? 62'-C' 13 -'A
If buying on contract: Owners name 0- simple owner
Contract recorded in Recorders 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 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:
hereby certify the above statement is true, correct and complete.
County Township
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 -
F I L 17 r D
True Ca sh
LLII
Value
Land not excee I 1 (one) acre immediately
surrounding res iaMW9ments
(1 ) a dr_rL
Other Lar7�j
Total Land
(2) —
(3) V-4-
Residential I provement�UDITOR
(4)
Dwelling
g f
(5) S aSlo
Garage
Total
(6)
Other Improvements
(7)
T( Tr' Improvements - Line (6) plus (7) equals
(8)
(8)
by certify the above is true. correct. and complete.
Si9namre of Assessor
_
ACTION BY AUDITOR -
Approved
Assessed
Valuation
Gk
Homestead
Valuation
Dale
STATE FORM!Kt.,r/.Wl nIAStl&UA?OLM 75-M
APPMWEO BT STATL DCWIDOF 11 MINI PP/SCRUMBY rnr DEPARTMENT(f LOCAL D(naRVMrN,FD:A CE X'H.Id'J.I
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.Ilomestead fraud causes higher tar bills for all:therefore.
HEA 1344-21109 requires uspa)ers who remise the homestead standard deduction to verify that they ore eligible to remise the
benefit and to provide additional identifrmr information necessary to allow county gust-rumen: to better monitor homestead
filings.This information will he tryst confidential and can only hr accessed by authorized county officials.The Depanment of
Local Goverment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Stevens, Tony D/Pamela
104 Vine
Patoka IN 47666
537
Tony D/Pamela Stevens
•
Po Box 243 State Parcel Number Lezal Description
Patoka IN 47666-0243
l t l l l l l l l l l l l l l l l t l l l l l l l l t l l t t l l l l l l l l t t l l t r l t t l r t l l t t l l l l l 26-04-24-304-000.359-020 018-00359-00 COL DIV 48 PTn3 PT
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
I dir\ dull El S-{eu-en c s2 ,
®Ti Address(number incli street,city,state,and ZlPlc(rooddee)Y. - — ---' - _I,, _ ___E Same as property address- __
0 vpc e- l c-t�0(q �� -l '7 V 'v'n Part below)
Spouse First Middle Last
ffi M S-Eeuf4c
Mailing Address(Number and street,city'•state,and ZIP code) I r w Same as property address
I () I E UI►1e PGfioWe I Pl 97666
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 hack taxes and substantial financial penalties.
Owner I Signature Date
PART 4: ADDITIONAL INFORMATION