Homestead_SchmittFORM HC 10 1979 w To Be Filed in Duplicate
Prescrited By State Board of Tax Commissioners
t�
CLAIM FOR HO(M�E�STER0 -PROPERTY TAX CREDIT FOR YEAR 19Z2—
9£� &CK FOR FILING INSTRUCTIONS
�(We) certify that on the 1st day of
March, 19 79!, I, (We) oc pied as our principal place of esidence the following described real property for
which a Homestead Prope y Tax Credit Is hereby being claimed:
I, (We) D owned
H are buying under contract
❑ have a beneficial - interest in the taxpayer
Property Description in 2 4.. /� Countyo Township
Taxing - District (City, Too i Township) -!
Parcel Number I I I I I I or legal description shown on tax statement:
If buying on contract: Owners name ,flee simple owner)x p'f g - p9�t Al
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.
ignature � Sheet Address City. Stale �p Code
Individual either owns or is buying �nder a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other Land
Total Land F I L E
Residential Improvement Dwelling
MAY 211979 Garage
�//� Total
Other Improvements qt r /K-e4&
Tour Improvements Liner ) plus (7P�gM"(8)
1 #by certify the above is true. correct. and complete.
Signature
Ap
True Cash Assessed Homestead
Value Valuation Valuation
(1) J 00 / 7n
(2) / a o
(7)
�E
- ACTION BY AUDITOR -
Z01111011i
STATE FORM 53569(RMS-10) TREASURER FORM TS-IA
APP70YED BY STATE BOARD OF ACCOUNTS.22009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GO VERNMENT FINANCE 106-1.I-22-8 I
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS ''
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
.eduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
`causes higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
standard deduction to verify that they are eligible to receive the benefit and to provide additional identifying
information necessary to allow county government to better monitor homestead filings. This information
will be kept confidential and can only be accessed by authorized county officials. The Department of Local
Government Finance will use this information to create tools that will help county officials eliminate
homestead fraud.
• ;r; w- • PART I PROPERT,Y'INFORMATIONr, J!r r • 1' t°'a ":'_
Taanare-Name property Address State Parcel Number Leos)Description:
Carolyn Schmitt 6783 S SR 57 26-20-14-100-000.888-001 PT N NW 14-3-9 1.23 AC
OAKLAND CITY IN 47660
Complete and return to: lR°s hymn ms tnpmnn tmn m t noprmm�nvnsnaPnn
IulliilJUUi iEllit inin u311310uKiiiiiuiiiiiiu�m
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PART 2:TAXPAYER INFORMATION -_ .: A'Y.•'i-• "
Owner 1 First Middle / Last
<A2 / e . / .
?mane Address(number and strehz4 ate and ZI /,/�,(//y/� (7//��/'/��]//� 4�N,},// -
//1 r V 3 A4 ��l'v Vet."_ v / '� ;- Same as Yo - yes J ']/ t, ! 7A0
- .
Spouse First Middle Last
Uid ,
Mailing Address(number and street,dry,state and ZIP code) r i Same as property address
r
Social Seauity Nuneer(last 5 digits) Drivels License/State ID Hunter(last 5 digits) state Omer(please specify in Part 4 below)
. - P7\R P8 CI?R PtBtEAg IOi� a .
,.•.' , :'t 1 •: .. " r '^-.i. .-:� .°:: :3a-�':'F"�"5:10713�5.'s�s
eto 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.
ignatue Date
..;;?: -: `
Fit ba
NOV 1 3 2012
ca "
t;IBSON COUNTY AUDITOR