Homestead_Hillyard SIAME EOM.'•):HIR:r}*MI TPFASU[rJ MIN TS-IA
APPROVED BY MATE W WOOFMYV RI\'t5.9n PRJ3NBED nY T11E DEPA0.ne4T(4LEX'AL GOVERNMENT FINANCE IC 4-1.1-2:4.I
Gibson County Auditor
101 N IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
Wain
C\ PRINCETON IN 47670 Individuals and married couple are limited to one homestead standard deduction.As the receipt of this deduction becomes
dip more beneficial,there is more incentive than e'er for homestead fraud.Ilome;read fraud causes higher tar bills for all:therefore.
HEA 1343-2009 requires taxpayers who reecho the hanesa-ad standard deduction to verity that they are eligible to reecho the
benefit and to provide additional identifvin_ information necessary to allow county government to better monitor homestead
filings.This information will he Lop confidential and can only to accessed by authorized county nficial.The Depannml 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
Hillyard, Ralph L Jr/Linda L
106 N Fastview
Fort Branch IN 47648
7792
Ralph L/Linda L Hillyard Jr,c
106 N Eastview State Parcel Number Legal Description
Fort Branch IN 47648-1202
26-19-18-304-000.308-026 011-00308-00 HOLCOMB ADD 38/39
t o esI t I I i I n I I n I nn I I I t I I I III'tin I I n I I nt
' PART 2: TAXPAYER INFORMATION
Owner I First Middle last
RR LP// G /1/Li.-r-4-/Z6 R.
�ng Address(number and street,city,state,and ZIP code) i lilidAnie as property nddiess " - -
/oG e E/nSryf a S T Fr. ,&ngoi ?'.J V76 sit
Spouse First Middle Last
ZlAJDR I_ /1/4 ty/9-lA
Mailing Address(Number and street,city,state,and ZIP code) alurne as property address
/DG Al. b/ISTY/t& Sr. Ir '6RA,Jd AI Zr✓ 1/7/011J
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 a // Date
FOflM HC 10 79i9
ResaiDeO By Siare Bw�a ot taa Commissfoners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 191�L
To Be Pi@G in Ouplica�e
SEE BACK FOR FILING INSTRUCTIONS D03DS'`O�
�/ i
�'(We) � � � • � �ti^-�R- � • ce�� that on the 1st day of
�vlarch, 19�`L, I, e) occupied as our principal p ace of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed: ' "
I, (We) L�I owned
❑ are buying under contract
❑ have a beneficial inpte�rest� in. the taxpayer
Property Description in /�r County � Township
Taxing District (�it�; Town,�ervnship): 3ti- �-4-�--��
Parcel Number or legal description shown on tax statement:
�-�Q. �.�-�( . � � J 3 `i
If buying on contract: Owners name ��� simWe owner�
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:
�hereby certify the above statement is true, correct and complete.
County
Township
' Individual either owns or is buying under a contract thai provides.he is to pay the properiy 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 Lantl
Total Land
Residential � ro�emer�s �
�
JU��i 51979
True Cash
Vatue
(�) / o m o
(2) —
(3) / D o 0
Dwelling �4� � ��— � -�°� "�
Garage cs) 33390
Total (6) �
Other Improv ents
T ' Im em - e(6) 1 equals (8)
I�aby certi� �ie a o rrect, and complete.
.a..�'— �- .
$igndlOR OI A552550�
(7) —
(g) "` � � ' �-'
- ACTION BY AUDITOR -
Assessed
Valuation
� yo
.
jj�jjjjj/�/
�jjj/j/
_ � _ �
Homestead
Valuation
� � 9�
�'�'L,ctJ,.., 2"2 i/- 1 7 9
Oa�e
Date: �/���� .