HomeMy WebLinkAboutHomestead_Burris :TAIL FORM 5.1.5w,Rj1%-let IRIASURU I(LLV ISIA
• APPROVED BY TUE(RnRC OF At(*NT..;o-u rRtiCRIWF.)01 TX/ULPAR1101 OF LOCAL COVUIMILNT}LCANCE tr sitars
Gibson County Auditor IMPORTANT NOTICE.TO HOMESTEAD PROPERTY•OA ERS_-
11011 N.Main Street Individuals and married couplets are limited to one homestead standard deduction.As the receipt N this deduction becomes
P,iQh I` 76�' mom beneficial.there is more incentive than ever for homestead re
d fraud.Homestead fraud causes higher tax bill,for all:therefor..
• 1 L II EA 1344-2004 requires taxpa'ers who receive the homestead standard deduction to verify that they am eligible to receive the
benctit and to p.m ide additional identifying triornauon necessary in allow county government to better nxmitor homestead
filings.This information will be kept confidential and can only-he accessed by authorized county officials.The Department of
Local Government finance will use this information to crane tool,that will help counts.officials eliminate homestead fraud.
APR 10 2012 PART 1: PROPERTY INFORMATION`:•
Taxpayer Name Location Address
Burris, William S/Carmon C
802 E SINCLAIR ST
GIBSON COUNTY AUDITOR
FT BRANCH IN 47648
2430
William 3/Carmon C Burris
802 E Sincair 111111111-M1111 111 1111 111 I [lID/1101111 Iii IH 111111 $11111 1111111- 111111
Fort Branch IN 47648-9799
III"II'IIII�Ittllllrll�Illttl�I�iliIIIIIIIuIllllllllllllllalltlr State Parcel Number Legal Description
26-19-18-302-000.107-026 HILLCREST 22
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER 1NFORMATION•:
..er I First Middle Last
l l it a Yn s e i3 u R R is
Mailing Address(number and street.city.state,and ZIP code) n Same as property address
$O2. C.S;tic//af Si% $ ," 4147G 4
Spouse First Middle Last
(' CL 'rrnolZ e , Barn`s
Mailing Address(Number and street,city,state,and ZIP code) / ❑ Same as property address
S z f• -J i/l c /0, :r $t r n , ---i- 7 fo 4.g
— -- - - -- --- — --
• 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 sigma' vw Date
PART 4:ADDITIONAL INFORMATION.
'FOfl1A HC 10 1979
He5cn0ed By Staie Boara of ia. Cammissioners
To Be Filea in DuDlicaie
CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOR YEAR 19 79
SEE BACK FOR FILING INSTRUCTIONS
�(We) \/� �//1-�-. 05• � �`a-�-.ti- �� 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) ❑ owned Q��—c�%4/ �Q 7 Q�
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in ,� County �� Township
Taxing District (City-Town, Tawaskip): �/� • �/�-ci,c-��
Parcel Number or legal description shown on tax statement:
.�Cl�'°'t' � oL.
If buying Ofl contract: Owners name ��� simple owner�
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 [o 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.
J //// �
S[rrei naaress
County Township
Ciry. Siate ano Zip Coce
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 ihe taxpayer.
- FOR ASSESSOR'S USE ONLY -
True Cash
value
Land not exceeding 1 ane) acre immec�i�atel�
surrounding residentia�impr�vem �s (� ) / � 2,0
Other Land �2) —
Total Land
.1tlh 1 3 1979
Residential Improvements� / ,�/i~����„Welling
V
�� � � 6 '�/ `G�arage
AUDITOR Total
Oiher Improvements
Tc++ I_ Improvements - Line (6) plus p) equals (8)
i�:by certiiy the above is true. correct. and complete.
SgtNWre ol Fssessor
Approved
�3� /�lao
(4) ��"
(5) oZ.��.S�
(6) �
(�) —
($) �a
- ACTION BY AUDITOR -
Assessed
Valuation
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Homestead
Valuation
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Date: _