Homestead_Moore (5) • SAIL r(1RM 53•t4(Cl(u'I 1Tr.1N[FA FORM 73-IA
APFR(WFO NIT s[O[aMRO(KAnn ANTS T+ PLEWWBFD BY airDEPARMENT OF LOCAL tswrLYMrsT FINANCE ICN.I. -AI
Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple 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 tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recci'e the
benefit and to provide additional identifying inform-ton necessary to allow county government to better monitor homestead
filing..Dais informanna will he kept confidential and can only he accessed by authorized county official..The Deponent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Moore, Herman N/Vera S
Buckskin IN 47637
8769
Herman N/Vera S Moore
8709 S 850E State Parcel Number Legal Description
Buckskin IN 47647-9003
IrlrPllt trltlllrr1tt 11rt r11rlr tllrrt ll 11r11rr r1r 1llllu 111 26-20-27-100-000.549-001 p X 549-00 BUCKSKIN 14
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
--fig.Address(number and street.city,state,and ZIP code) - - [}2C as prapeity odd& -- - - "- - -- --
Spouse First Middle Last
ILI2e •
Mailing Address(Number and street,city,state,and ZIP code) ❑Same as property address
Social Security Number(last S digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sus
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 1 Signature y�� Date ,
FORM K 1D 1979 To Be Filed in Dupliute
Prescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 1979 /
SEE BACK FOR FILING INSTRUCTIONS ✓
0 m0541 -00
P(we) '9-55� certify that on the 1st day of
arch, 19�, I, (We) 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) Lg owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in G'X a County g v- Township
Taxing District rGit , Tewrt-, Township): ";I�
Parcel Number
If buying on contract: Owners name flee simple ew-er)
or legal description shown on tax statement:
Contract recorded in Recorders Office - Record No
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
c o 2 c X00- 00d.5W-C)6/
Any other counties in which individual owns or is buying real property: County Township
hereby certify the above statement is true, correct and complete.
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
Total Land
Residential
Improvement
L E
welling
Garage
JUL 271979 Total
Other Improvements ����1111
Tn+ I Improvements Lips6) s e a s)
-by certify the ab�v/e115 e. correct. an complete.
n / o-A— - AUDITOR
of Assessor
True Cash Assessed Homestead
Value Valuation Valuation
(1) S"00 170
(2)
- ACTION BY AUDITOR_:
/ /.% 1I�
• z .
Dare
Approved: Date: 7-Z-7- 2 9