Homestead_Cummins •STATE FORM TAN. Lr(v0I TREASURER FORM TS IA
.ATIR(A'En PT STATE PMRO OF ACTT AT a.Two PRLVIIUBFntY THE DEPARTMENT OFROCAS.GOVEtNMn.T E a:ANCE IC 6-I.1-::.r.I
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 eter for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 13-14-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reeeene the
benefit and to provide additional identifying infomlatiun nece%sary to allow county government to better monitor homestead
filing_This information will he kept confidential and can only be accessed by authorized county officials. the Ikpanntenl of
Local Government Finance will use this information to create mull that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
• Cummins, David L/
206 S Walters
Fort Branch IN 47648
7732
David L/ Cummins
206 S Walters State Parcel Number Legal Description
Fort Branch IN 47648-1437
II III I II I III I III III I I II I 26-19-18-303-000.244-026/011-00244-00 WALTERS ADD
to tarr tarst nnn r n n rite stn a tar t/ 342PT/343PT
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
r
�U� d Lem O? T ;As
ing Address(number and strut,city,state,and ZIP code) a as property address
a0 I illaSiatd ctfran cl, Al Tert-R
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 tha4 by"claiming-additional-homestead-deductions _
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Ot• CT 1 Signature Date
•
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
sr� rv�,� s�r3 (R� i s-ae)
FrearJibad ty a,e oepeNrenl or Lom� covertunern F'vanm
� INSTRUC710NS: See ieverse side (or filing ins6ucfions.
�{
P�,` �
FORM
HC10
I iWe) �^-�i K�C \/ I � , at M�Cf� 1��Y� M9rch, 20_
I(We) ocapied as our prindpal place oi residence perty fw whiG� a Homestead Pro Tac Credit is hereby daimed:
❑ i c�) � ❑ n�e o�,ymy ��a�r �«,vaa � U��
�Have a berefidal interest m tt�e entity that is liade tor the propeAy tarzes m the {xoperty and that ams the �bW��'uAtlCDl�fi�tracl
n�Y�9 an cmVad. Fee Sirt�le orrels name
�
Gl
wWad "u ranrded
Tumship
descnPlian
Recard number � Pepe
fown. favnship) /'�
l`ti%
u�quesbon:
� P�b
H a`ry portion oF the residentiai sWGUie a tlre Imid no1 mcceedirg one (1) aae Ihal'unmedialey surtaunds Ihat
d Uie property uli6md b produce mcome.
Twvnship
I hefeby certify the above statertienfs are We. carrecf and complete.
County
of daimarrt
MaCila Fbrtre (/.C. 6f.1-n
is used tu pmduce mwme, tlescribe ihe uw end portion
Ad�as (nunbei end atreet dA: . LP e)
�P��.C� �� 1�n I�P rs �-� . 1� rG n �_ h. I a( �!-%�1-