Homestead_McGillem (2) STATE tots.53 iriYYI flfASttIR fn0.V73-IA
APITCWEO BY SIAit BOARD OFM'na"Aif.:Non Ptr,VNAFW BY TIM DEPARTW TOr LOCAL C vourstner FP'ANCElc I.1-I_-r.l
GibsaneCounty Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple. are limited to one homestead standout deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tax bills for all;therefore.
HEA 1344-2009 require uxpapers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to pimide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only h•accessed by unbound county officials.The Depanmenl of
Local Government Finance will use this information to create nuts that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
McGillem, Larry/Judith K yyy
R3 Box 85 A
Oakland City IN 47660
8413
Larry/Judith K McGillem
4708 S 1025E State Parcel Number Legal Description
Oakland City IN 47660-7666
If if tllntit ilutllnllu tlntitliurilnfllulintlnlulttil 26-20-02-202-000.604-001 001-00604-00 PT NE 2-3-95AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle '�}y--�L+ Last
Larry �c, sarh )/ ) C; I )ekr'
ag Address(number and street,city,state,and ZIP code) - - - U Same as property nddres ---'- -— -
11- $ s 1 a:t F , Cork la u cl e\*y N 47 b (, o
Spouse First Middle Last
0-C tti Kai Crne-C-, ,y,
Mailing Address(Number and streek city.state,and ZIP code) n Same as property address
u1io g s (oas Qa.k load. Cf 7 , a_ A/ 4? Iv Co ,
-- — - -
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 HC 10 INS To Be Filed in Duplicate
Prescribed By Slate Board or Ta, Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 �
SEE BACK FOR FILING INSTRUCTIONS
/�,/ �� 001' oo1,oK -p0
,;We) ��/ QD, "' j � t w L certify that on the 1st day of
warch, 19—,7�I, (We) occupied ur principal ace of re-sid`encqohe following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
dG -ao
I, (We) P owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description i
Taxing District (Gi , T-ewm Township):
Parcel Number
If buying on contract: Owners name nee simple owner)
Township
or legal description shown on tax statement:
P &. /Vo� --? -9 2t�-
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
hereby certify the above statement is true, correct and complete.
0-
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 iqWdiately
surrotinding residential improve mer
Other Land ff��
Total Land
IL—
Residential Improvements JUL , 1f�Z611ing
Garage
� Tt
Other Improvements AUD)rOR
Tr.'-' Improvements - Line (6) plus (7) equals (8)
I by certify the above is true., correct, and complete.
S,.rure of Assessor
True Cash
Value
(1) S"00
(2) 6 X0
(3) // FAQ
(4) /F4�, .Z7
(5)
(6) / 2O
(7)
(8) Z -g 6,
- ACTION BY AUDITOR -
Assessed
Valuation
s
=RZ-2�
IWO
�0
Homestead
Valuation
Date: % 310