Homestead_Burns (4) 7
51.51E FORM!Ay+IR F'.rv1 ^ nrASURrR FORM 75-IA
.APPROVED BY STMT.IYWmn11n.NIs.Yv PRr1WBED BY 71IE DEPARTMENT OF LOYAL CM£emmon'rNA\CE IC 1.1.1.214.1
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 tax hills for all:therefore.
• HE:\ 1344--200)requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing.'Ibis inl'ormatinn will be kept confidential and ran only be accessed by authorized county officials.11w Depanmcm of
Local Government Finance will use this information to create tools that will help county officials eliminate hmoes:cad fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Bums, Frances E Trust
309 S Hillcrest
Fon Branch IN 47648
7882
Frances E Bums
309 S Hillcrest State Parcel Number Legal Description
Fort Branch IN 47648-1617
26-19-19-102-000.106-026 011-00106-00 PT NW 1
Itlrrllrltlll'lll'tlllll'rlrr II II Illrrr III rrrlrlrllrttll &310.25 AC
X
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Frd N c e S Burris
g Address(number and street.city,svte,and ZIP code) - - - tC-Same as property uddfess -— — -- ---' "-
3o75o, N ; LLcresT For% franc-}1) 77, '�{Lr7byr
Spouse First Middle Last
Mailing Address(Number and street,city,state.and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sr=
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 elieible 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
•
warn xc io isn
Preuribe0 By State 8wr0 af Tax tommissioners
CLAIM FOR HOMESTEAO PHOPEATY TAX CREDIT FOR YEAH 19 � 9
To & FileG in Oupliwte
SEE BACK FOR FILING INSTRUCTIONS �/�_ Q�/ �/�! AO
-c /� U U
�(We) � �� , �O' '� J,-�4t� �� certify that on the 1st day of
arch; 19�, I, (We) occupied as o incipal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description
Taxing District (r�Town, TewnsFri�): �`"-
Parcel Number
It buying on contract: Owners name (�� simD�e o.�e��
_[%fin.c�vrJ Township
or legal description shown on tax statement:
�,t • Nii���� i 9- .3-i o. a� A
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
Any other counties in which individual owns or is buying real property:
�hereby certify the above statement is true, correct and complete.
County Township
�c' % ne,rN.4,2 �
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.
�jLE�
- FOR ASSESSOR'S USE ONLY -
MAY 2 3 'f979
Land not e�x ding 1(one) acre immediately
surroundi�ksi tia provem ts
Other Land � �
Total Lantl AUDITOR
Residential Improvements
Dwelling
Garage
Total
Other Improvemenls
T�( �' Improvements - Line (6) plus (7) equals (8)
I�`#by certify ihe above is irue. correct. and complete.
Signa;ure of Asseswr
True Cash
Value
(�) y�.o
(2)
cs� ya,o
(4) �fl
(5) —
Assessed
Valuation
3 i o
3i o
Homestead
Valuation
,3 / o
(6) ��'—�9—��'8��0 _SL..3.�ca - �!. � i .-,
«�
(8) /�`�'�
- ACTION BY AUDITOR -
�
`7'�'La�.� � '7 � 9 'Y 9
Dare �
ApprOVed: �_� / / � � � p �� Date: -- �.3, l97 �
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