Homestead_Gwaltney _ Sl V E FORM 53!e0la_/fwt nEASURFR FORM ills
frPReWEO BY'rut BMRD OF MTr4PTS.9r Mtl[WBm BY THE DEBARMENT/RRAL O VERNYI.T Ft:.44CE lell.l-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 incenthr than eser for homestead fraud.Homestead fraud causes higher lax bills for all:therefore.
• HEA 1344-2009 requires taxpayers who retire the homestead standard deduction to verity that they are eligible to recehe the
benefit and to pnwide additional identifying inform:noun necessary to allow county government to better monitor homestead
iilings.'nlis information will he kepi confidential and can only be accessed by nuthnrieed county officials.The Department of
Local Government Finance will use this information to create teols that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
—. Gwaltney, Lawrence/Betty
704 E Walnut
- - -- _ - _ - - _ -. - .__ . Fort Branch IN 47615 -. _
7791
Lawrence Gwaltney
704 E Walnut State Parcel Number Legal Description
FORT BRANCH IN 47648-1238
I I I I III I I I I I I I I III III I I I I I 26-19-18-304-000.279-026 011-00279-00 HOLCOMB ADD
to net ntn iisett nrn fait useien t B1PT/82/83/84
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
wRENc6 A 6WAz->'AJi
ng Address(number and street.city,state,and ZIP code) i— — - — ❑ Same as property nddmss— lI -- — --- -- ----
7Dif E. Wiaz- Na .9f. Fo27' 8 RA NCH su it-76Cg
Spouse First Middle Last
8EV'7 � CWA4-TNCy
Mailing Address(N bcr and street,city,state,and ZIP code) J ❑ Same as property address
7°4 6 WA LNu i .57 1dR 7 k,! IT I Al Cf/
,
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 1 ignatute Date
•
•
FOpM HL 10 1979
heuribe0 By State BaarO of Tax Cammissioners
CLAIM f0A HOMESTEAO PROPERTY TAX CAEDIT FOR YEAR 192�L
Ta Be FileO in Uu0licate
SEE BACK FOR FILING INSTRUCTIONS D//_D�� -�Q_OO
l ��
�(We) �����-�-n-P-e- �!�� certify that on the ist day of
�arch, 19� I, (We) occupied as our principal place of residen e the following described real property for
which a Ho/mestead Property Tax Credit is hereby being claimed:
I, (We) Ild owned
❑ are buying under contract
❑ have a beneficial intenwrest in the taxpayer
Property Description in 9�/--�-�--�-M County ��- Township
Taxing District (�ity; Town, Iowaship): �mh-f /�/�-s-,��_.
Parcel Number or legal description shown on tax statement:
If buying on contract: Owners
�i=P�t Pz g3�8�
pc.a P�n 5�Z Pt ,_ ,
Contraci 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:
�hereby certify the above statement is true, correct and complete.
Sheet
County Township
.w� �... , �76 4 �!
Ciry. StAce an0 ZiD �e
5-�8-%9
' 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 -
�,�L �'7 � True Cash Assessed Homestead
'��� Value Valuation Valuation
Land not exceeding 1(���a�rg. i�9diately
surrounding residential i o ibe
Other Land � �
Total Land �''
Residential Improvements A�DITOR
Other Improvements
(1) �OaO
(2) --
(3) �v �—o
Dweliinq (4���"s
Garage (5� °Z rd 7 �
Total (6) ���
To'-' Improvements - Line (6) plus (7) equals (8)
I�y certify the above is true. correct. and complete'
� ��n__� z,
Si9^amre oi
(�) —
(8) �
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