HomeMy WebLinkAboutHomestead_Cyphers MATE FOtM 5).w,llt was TREASUIf1 FORM CS-IA
• APPROVED BY)TBTE B[MRD tN M'YB•T‘.b.• PRF`1rAIDFD BY II"OFP,an MTOF LOCAL rawrt`zMrwr FINANCE M 1441_41
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 ever for homestead fraud.homestead fraud causes higher In bills for all;therefore.
HEA 1344-2019 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to receive the
benefit and to preside additional identifying information necessary to allow county government to better monitor homestead
tiling.This inlurmatinn will he kepi conlidrntial and can only be accessed by authorized comity officials.The Department 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
Cyphers, Otis M/
703 'littler Park DR
Fon Branch IN 47648
7700
Otis M/ Cyphers
703 Tretter Park Dr State Parcel Number Legal Description
Fort Branch IN 47648-1221
1.1.1 1,,,I.1 1 III II II 1111��II 1III 1IIII . II III 1.. 26-19-18-302-000.682-026 011-00682-00 TRETTER PARK 20
Spouse First Middle Last
O 11 • /14— - P E /ZS
Mailing Address(Number and street,city,state,and ZIP code) ktg.Same as property address
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is taste 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.
PART 4:ADDITIONAL INFORMATION
FOPM HC 10 1979
PreSCri�eU By Slate BwrA oi iaz Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOR YEAR 19 � y
To Be Filea in Duplitdte
•�
� LI �%�l� ��C�oACK FOR FILING INSTRUCTIONS D� /'QO /��� O�
' � N ! �m _
�Ve) ��� certify that on the tst day of
,ch, 19� �_, I, (We) �cupied as our 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 (6iby, Town, Ta�acnsbip): �%
Parcel Number
If buying on contract: Owners name �'� �""o1e °"'"e'�
��
Township
or legal description shown on tax statement:
o//�- (Y� . �.o
Contract recorded in Recorders Office - Record
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:
�
certify the above statement is true, correct and complete.
County Township
� " �30��j
' Individual either owns or is buying under a contract th�at p�rovides he is to pay Ihe properry taxes
� on��r siden� o�has �be�ia�In�rest in the taxpayer.
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� FOR ASSESSOR'S USE ONLY -
- � (',�(a,). 4� 3 0 ��7g
��/- r�' �' True Cash Assessed Homestead
Value Valuation Valuation
Land not exceeding 1(one) acre immediately�%
surrounding residential improvements �J� � � 8 3 0
Other Land AU�TOR —
Total Land
Residential Improvements Dwelling
Garage
Total
Other Improveinents
/ �tnprovements - Line (6) plus p) equals (8)
��� ,�y certify the above is true. correct. and complete.
SignaWre ot Assesme
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- ACTION BY AUDITOR -
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Date: �- 3�' � /