HomeMy WebLinkAboutHomestead_Heichelbech tlAME f ORM!Mg*OCIY041 TREASURER FORM 711A
APPROVED BY MATE BOARD OE Ant.NI,.?an RRra(AIBW BY Tllr DEPART2WT(W LOCAL rOELMMEM ra:AMFEMS1.1.21.1.1
Gibson Coup:y Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCJ*TON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
IP more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher lax bilk for all:herefere.
HEA 1544-2004 requires mxpascrs who receive the homestead standard deduction to verity that they are eligible to creche the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
hlinga. Otis inhumation will he kepi confidential and can only he accessed by authorized cranny officials_The Department of
Local Goverrenent Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name
Heichelbech, Jeanette
R2 Box 122
Fort Bran • . 648
:9
Jeanette Heichelbech
R2 Box 122 State Parcel Number Legal Description
FORT BRANCH IN 47648-8606
I tI o I I OIII I u I I I I I I I n I I I I I I 11111111 26-20-17-300-000.317-001 001-00317-00 PT NE SW 17-3-9.78 AC
tt eo ietnu too of \�(/ D-8
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PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
1e.,irteibe__ KRy /ergs/be
•ng Address(number and soh,city,irate,and ZIP code) - - — —- - - ❑ Same as property nddicss -- - - --
�94/ E. c .A /49
Spouse First Middle Last
Mailing Address(Number and street city,stale,and ZIP code) Et Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
5=
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
FORM HO 10 1879
Prewilied By State Board of Tax Cominwoners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 1912
To Be Filed in Duplicate
E BR FILING INSTRUCTIONS OO /_p 0 317— 00�
��,We)��(��rla. ger certify that on the 1st day of
l—varch, 19—, I, (We) occupied as our principal pjfice of residence the following described real property for
which 'a Homestead Property Tax Credit is hereby being claimed: _
I, (We) ❑ owned a&l
❑ are buying under contract
have a beneficial intere t in the taxpayer
Property Description in County Township
Taxing District (64q -Tewn, Township):
Parcel Number or legal description shown on tax statement:
P1. 0/1'k gW-,''V 17--4-,9
If buying on contract: Owners
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
I
it is true, correct and complete.
Individual either owns or is buying under a contract that provides he is toXay tt
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 im2&ve ent$
Other Land
• 1
Total Land
Residential Improvements JUN 6 1979
Dwelling
Garage
Other Improvements
T Improvements - Line (6) plus (7) equals (8)
Iby certify the above is true. correct. and complete.
of Assessor
True Cash
Value
(1) .?'oo
(p) —
(3) S D o
(4) yo�o
(5) ?oo
(6) y -7 :7 o
(7) /30
(g) 2159 0 o
Assessed
Valuation
I%
X330
,:5-- 9 �9
Data
Homestead
Valuation
/ 7D
Approved: r _ • 9. Date: eal - 0""— 7