Homestead_Emge ■
• snit I ORM!Thsalie.I 5.0.1 n£w:rn RIM l.-iA
nrrK'm BY 51■15 BOARD K Mft.NT3.1'n PlialtIBED ar nit oer.. nAe`tr(W LOCAL G VELWF55 Fa:AWE IV 411--la
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&diction becomes
more beneficial.there is more incentive than net for hornes-.ead fraud.homestead fraud causes higher tat bills for all:therefore.
II HEA 1344--3010 requires taspa)ers who receive the homestead standard deduction to verify that they are elieible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
tiling.This information will be Lein confidential and can only be accessed by amhori.ni county rack's.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
_ Emge, Charles/ Margaret
507 S Cumberland
' Fort Branch IN 47&48
7005 •
Charles/Margaret Emge
507 S Cumberland State Parcel Number Leeal Description
Fort Branch IN 47648-1529
26-18-24-202-000.202-026 011-00202-00 PT NE 24-3-11 .85 AC
1tlrtllrrrltlittt1tt11tt1ttt11111rlrrt1tllrlttlltt1111ulltttll
PART 2: TAXPAYER INFORMATION
Owner I First n .� p Middle Q Last
me Address(r umber and street.city,state,and ZIP code) V- - I Some as property tw�es- --- -- — --
f l v
507 S CAAina.)3L' .d.$ It ?-1 i�. 1. 417 L S
Spouse First Middle Last
Mailing.Address(Number and sweet city,state,and ZIP cafe) ❑ 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)
sore _ . _
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 Signature Date
• .
FOflM HC 10 1979
Reuribe0 By SGte BoarE nl Tas Commiuioners
CLAIM FOR HOMESTEAD PHOPERTY TAX CREUIT FOR YEAA 19 %�i
To & FileE in Duplicate
SEE BACK FOR FILING INSTRUCTI,ONS �//,�o,?oa oa
(We) CO �A P'" � certify that on the 1st day of
arch, 19�, I(We) occupied as our principal pla of residence the following described real property for
which a Homestead Property Tax Credit is hereby beirig claimed:
I, (We) �wned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
�
Property Description in County �� Township
Taxing District (�iiy, Town, S�letnship): ��� � �-�`�
Parcel Number or legal description shown on tax statement: ,
Qt. A1 E�/.F �- �f -�- i i � 85
If buying Ofl contract: Owners name ��ee s�mo�e ow�er�
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 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: County Township
�hereby certify the above statement is true, correct and complete.
cvr.
' 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 Improvements Dwelling
� � � � Garage
Total
Other Improvem��a.� � i�79
Tc�lmprovements - Line (6) plus (7) equals (8)
I_ by cer th ab v is tr rrect. and complete.
, s-�
Signamre oi nssessor /�/ / �p��R
L t
True Cash
Value
(1) �oSo
(2) --
(3) �-o .i �
(4) �o--
�5> �o a � o
�6> -�-�
(�)
(g�
- ACTION BY AUDITOR -
Assessed
Valuation
(e`8o
�o �' U
.� r-
�
Homestead
Valuation
%%%��%%%�%/
jj/�jjj��j
`Y�.� i � �9�9
__ _ Oaie
Date: —�_S�? �