HomeMy WebLinkAboutHomestead_Kohlmeier STATE FORM:W..IR_/!-N1 not-sM-r A FOXY TI-IA
.APPROVED BY MATE MUD M'.Yf*l\'TS.br YATYRIBrn BY 7IIE DEPARTSC4T(F LOCAL nwcL Y.D,T FINANCE If 6-I.1-224.1
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 e'er for homestead fraud.Homestead fraud causes higher tai bills for all:therefore.
ask HEA 1344-2009 requires aspa'crs who remise the homestead standard deduction to verify that they am clicible to recene the
benefit and to provide additional identifying infurmmwn necessary to allow county gmemment to better monitor homestead
filings.This information will he kept mnfdential and ran only be accessed by authorized county officials_The Deparlment of
Local Gmrmment Finance will use this information to create tools that will help canny officials eliminate homestead fraud.
PART 1:PROPERTY INFORMATION
_ Taxpayer Name Pro erts'Address
Kohlmeier, Carol/Phyllis !;3 S t R DST
7
eA cAhibe,iynil
R I Box 158 4 766 D
Oakland City IN 47660
8597 O
Carol/Phyllis Kohlmeier
6373 S SR 57 State Parcel Number Legal Description
Oakland City IN 47660
26-20-11-400-000.423-001 001-00423-00 PT S 11-3-9 77.136 AC
_ . _ .—_ _ _ _._ _ ___ __ _ _ _ _ - __ ._ — _ _ —__ _ .
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
CAAbi, L • k4Al A. MYl L-/tA
IDAddress(number and street.city,state,and ZIP code) _ - 0-Same as property address--- — ' .-
b_.? 71 S smm RDS7 OflL tIV2J ell)/ IA) A'Yfee
Spouse First Middle Last
PT1yLi is SAN kDy zmEIsR
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as properly address
/aS7/ S STATE RD67 OA ELAN/ Cit>/ 7/Y 41/l a,
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 S. nature of Date
FORM HC 10 1979 To Be Filed in Duplicate
Prescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 197 s /
SEE BACK FOR FILING INSTRUCTIONS D l — 0 Z 3 —�O /
40(We) /f T� % certify that on the 1st day ✓ ✓of
arch, 19 —Z7'?-, I, (We) occupied as our principal p2ce of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑owned C19 -070 ��- TAU - eDd
are buying under contract
❑ have a beneficial interest In Ve taxpayer L
Property Description in County �°- Township
Taxing District (C-ity, Tewra, Township):
Parcel Number or legal description shown on tax statement:
-9- . ye. 7s
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
I hereby certify the above statement is true, correct and complete.
a/l /l
Township
Zip Cooe . y / � / -o
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)�re�mrterjia ,t D
surrounding residential imp Fe t
True Cash Assessed Homestead
Value Valuation Valuation
(1) 3-00 170
Other Land JUN 12 1979 (2) 7 7 Romeo
Total Land (3) 8 a A 0
Residential Improvements (4)
Lling
AUDITOf�arage (5)
Total (6) •70 7 3 0
Other Improvements (y) '11/10
T ' -' Improvements - Line (6) plus (7) equals (8) (8) 0 7 3 0
Irby certify the above is true. correct. and complete.
A
Signa:y of Assessor - _ -
(/ ACTION BY AUDITOR -
Approved
M
17
n G
Date: