Homestead_WilsonppPp"I' 1979
""' !By State Board of Tax Commissioners
/ CLAIM FOR
HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 717
SEE BACK FOR FILING INSTRUCTIONS
JLV. 4-
I, (We) occupied as our principal place of resleni
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
Taxing District (6ity; Town, Towp,&"): l7c
Parcel Number
If buying on contract: Owners name I'ee simole owner)
To Be HIM in Bupliule
certify that on the 1st day of
the following described real property for
Township
or leegn,^,
gal description shown on tax statement:
C:�-� . &;-, , 07 - iP-F , d- a 6 t 4. �G
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
certify the above statement is true, correct and complete.
'Signature a Street
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 -
Land not exceedin�i (o e) aLe imia I
surrounding reside El i prov ent
Other Land
Total Land N�AY 2 X979
Residential Improve�r)lyepts x�� Dwelling
AUDITOR
v` Garage
(((///
Total
Other Improvements
Tnr ^I Improvements - Line (6) plus (7) equals (8)
-, certify the above is true. correct. and complete.
Signature of
True Cash Assessed Homestead
Value Valuation Valuation
• % % % % % �✓//l %
- ACTION BY AUDITOR -
Approved: _4 Date:
r,
STSTE rotnl!Mt*,Rrt'Nl ThIASU EI FORM 73-IA
AP/ROVED BYSISTE FOSRD OF ACCOUNTS 9n PEffTImm BY fir DEtMTYn_YtwF LOCAL COVER.VSMTT'r FIKAYCE1ea-I.I-LJ.l
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 taxpayers who receive the homestead standard deduction to verily that they are eligible to teethe the
benefit and to provide additional identifying information neceesaIv to allow county government to better monitor homestead
filings.This information will he kepi confidential and can only he accessed by authorized county officials.The Ikpartmmt of
Local Government Finance will use this information to create tools that will help nattily officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Pruperty Address
Wilson, John W/ Beverly
Po Box 104
Patoka IN 47666
94
John W/Beverly Wilson
Po Box 104 State Parcel Number Legal Description
Patoka IN 47666-0104
Illttlltttlllltttlltttllttll IIIlttttlttllltEttlttlttllll 26-04-24-302-000.0.451-020 018-00451-00 COL DP/ 625PT26PT
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
To �h1 W/ LLP) vljLs°N
tg Address(number and sheet,city,state,and ZIP code) Same as property address
Po lfo)C /Gsz Penbl<8 Tr/ 4' 7666-0/0 /
Spouse First Middle Last
Mailing Address(Number and street,oily,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
Soy
PART 3:CERTIFIC,ITION ------- -- ---- . --
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 Si s re / Date
Spouse SignIture Date Telephone
( )
PART 4:ADDITIONAL INFORMATION
•