Homestead_Mallory •
CRAVE FORM!!H,R_r W,l 1REASUl1R FORM StA
APPROVED BY t 1AIL BORADOr ROOL\TN Moo PRESCRIBED BYi11L IMPARMENTOFLOL'1L GOVERNMENT FINANCE le NRI-r-k1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple are limited to one homestead standard deduction.As the receipt of this deduction becomes
di more beneficial,there is more incentive than eser for homestead thud.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 infommatun necessary to allow county government to better monitor homestead
filings.This information will he Lim confidential and can only lx 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.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Mallory, Archie/Norma Faye
306 S Main
Fort Branch IN 476-18
7015
Archie/Norma Faye Mallory
306 S Main State Parcel Number Legal Description
Fort Branch IN 47648-1512
1I1rr11 rrrI rI_I rrrI rrII rrI r rrrllLirlrrrrilrrlrllirrlrlll,Illrrl 26-18-24-202-000.478-026 011-00478-00 MCCRARY ETAL 76 PT
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
111-R A t w.__. fq-// o /2 y
Ifing Address(number and street,city,state,and ZIP code) - - — -- me as property address
6.
Spouse First e. Middle Last
4/o R m 4- PA yk-I , //o� y
Mailing Address(Number and sweet,city,state,and ZIP code) l tom{name as property address
So 6 3 . /9n/4) 5 r oc%apirldv uu,v- <V7 yc/ .
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
SI
FOqM HC 10 1979
Rcuribed By State BwN of Ta. Commissioners
CLAIM FOR HOMESTEAD PHOPERTY TAX CREDIT FOR YEAR 19 ��
To Be FiIM in DuD��wte
SEE BACK FOR FILING INSTRUCTIONS
�(We) `� """'`�"�w- ,�'��'t->^^— J�- certify that on the 1st day of
�v�arch, 19�q I, (We) occu ied as our principal place of residence th ollowing described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I. (We) ❑ �wned ��� Q� � %g O�
[B"are buying under contract �
❑ have a beneficial interest in the taxpayer �I
Property Description in G�� S� "' County U'�% /�^� Township
Taxi�g District (Ci4y,-Town, Towaship): �.� R a N �{�
Parcel Number or legal description shown on tax statement:
m�n P�a�✓(M�C.176,�+,
If buying on contract: Owners
Contract recorded in Recorders Office - Record
Ii 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.
�( ` � �,��-m_<.�z rYl �.P�sn-ti 30 � S 6 u -� h ��,'N �-� . 8R�
'$gnaNre ret AOOres Ci , Sute and Zip CoCe
' 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 Lantl �� � g � �
Total Land j�,8
Residential Improvements
� �LII� 1 • '�ling
Garage
�� T �
Other Improvements � p�prcpq
T��mprovements - Line (6) plus (7) equals (8)
I-�. �y certify the above is true. correct. and complete.
_�
Signd�ure o� A55255or
(�)
(2)
True Cash
Value
`' �
(3) 9 0 0
(4) (Q �-�--
(5) 9/� O
(6) o0
��� --
(8� o 0
- ACTION BY AUDITOR -
Assessed
Valuation
3ma
��
�l. N
7 lo � �
Homestead
Valuation
�mo
2+30—, � -
� i ��
S- � �f- - 7
oa�e
Approved: ��G.��.y�! Date: C-'/ j-75� `�--��