HomeMy WebLinkAboutHomestead_Fulling (2) MATE IneM!>KIR/Hnl MIXAMIPLR FORM 11A
APPIBT'ED BY CT.TL.NAARD OF MTh..TS.Zino PREYNBW BY MIE DEPARTMENT OF LOCO.GOVERNMENT ENA\CE M4AI.1i4.I
Gibsen 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 134-1-2009 requires taxpayers who receive the homestead standard deduction to verify tlut they are eligible to receive the
benefit ark(to preside additional identifying information necessary to allow county government to better monitor homestead
filing..This information will he kept confidential and can only he accessed by authorized enmity officials.The 1)epagment of
Local Government Finance will use this information to create tools thai will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Fulling,Allen F
R 2 Box 307
EI 'meld IN 47613
3299
Allen F Fulling
7993E 900 S State Parcel Number Legal Description
Elberfeld IN 47613-8437
ir�lrll...1.11 11111111 liltIli.11111,1r 11111 Itt rrlit rlriti 26-20-28-100-0000.251-001 p� 251-00 PT NW 28393.08 AC
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 I First Middle 1 Last
4-1 e N ru.,N, 4/9
rut Ad le(number mid street,city,sate,and ZIP code) as property address
� � 3 boo /4fe-reiTame)✓ 17761 /2
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) O Same as property address
Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
_ _ _
PART 3c 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
J
FORM HC 10 1979 _ to Be Filed in Duplicate
Prescribed By State Board of fax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 7 q
SEE BACK FOR FILING INSTRUCTIONS
ool- oozs/-oo✓
(We) U' - certify that on the 1st day of
arch, 19tr I, (W occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned C-,)?6 — .4 d —o? 3,2 /60 — el-w
❑ are buying under contract
❑ have a beneficial interest in the taxpayer /�
Property Description in �/ �8 n County 17 Township
Taxing District (Sir, TeAR Township): l'7
Parcel Number or legal description shown on tax statement:
At. Ala) ir 8 - _I
If buying on contract: Owners name flee 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: County Township
I hereby certify the above statement
is
correct and complete
(v 7 /O
(s)
l 90
/true,
(7)
e — / Street Address V Citf. State and Zip Cope
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 exceeding 1 (one) acre immediately
surrounding residential improvements
Other Land I n L- E
Total Land F
Residential Improvements Dwelling
JUL 11 1979
Garage
X/J Total
Other Improvements r
Total Improvements Line (6) plu #401 itals (8)
I iWy certify the above is true. correct, and complete.
OI Assessor
True Cash Assessed Homestead
Value Valuation Valuation
(1) joo /7o
(2)
(3)
3 0 0
(4)
(v 7 /O
(s)
l 90
(6) 7Aio
(7)
/ c o
(8)
7 4 90
- ACTION BY AUDITOR -
-- «•sue j�j��jj /�j
Date
Approved: �� 1G� Date_