Homestead_Ort SIAIE FORM a/YNIR:/rAI 1PEAAIIEA FORM-SIA
■PPROVED DV tI ift.1101RD OF AMR S15..".w PRGYAIBED by 111E DEPARtxCvrxFUR:M rAI£RVMr,cr FuvsCE MO-LI-"AI
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 incentive than ma 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 recei.e the
benefit and to provide additional identifying information necesr-nv to allow county government to better monitor homestead
filint..This infmnuuon will be kepi confidential and can only be accessed by authorized county officials.The Delanment of
Local Government Finance will use this information to create twls that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION .
.. __ _ - —.- --- --Taxpayer Names--'� ,-_Property Address
Ort, Robert Wayne
207 N McCreary
Fort Branch IN 47648
1114
Robert W Ort
207 N McCreary State Parcel Number Legal Description
FORT BRANCH IN 47648-1010
II fiIII n II I nIII I III I fiI I fit' I III 26-18-13-404-000.581-026011-00581-00 SYMONDS 196 PT/197 PT
o
t t t fit il n t ion fi r
PART 2:TAXPAYER INFORMATION i
Ow \^,, First \ Middle Last
q Or A-
fig Address(number and strict,eitY,state,and ZIP code) — --- - -- -— Saute us pmpet is address- —- - —
0)o -1 INl rn` r=recs.r-y 54-
Spouse First' Middle' Last
Ma Hine Address(Number and street,city.state,and ZIP code) R1•ame as property address
0)01 N ' rMOQ Lrpou H 5k- .
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 Si tare Da"
O
•
•
FONM HC 10 1979
heuriCeE By Stam Board af Taa Commissioners
.. ' To & FileO in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CAEDIT FOR YEAR 19 � y
SEE BACK FOR FILING INSTRUCTIONS
- o/� D�`�� o0
�(We) �n-t, ' � �� � ��' - �' � certify that on the st day of
arch, 19��, I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
O are buying under contract
> ❑ have a beneficial in rest in the taxpayer
Property Description in , County � Township
Taxing District (CiLyrTown, Taacosbip): �- ��-e-�---�
Parcel Number or Iegai description shown on tax statement:
- �- J9G�i97
If buying on contract: Owners name �'� �'^'v'e °w^e��
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: County Township
�`�ereby certify the above statement is true, correct and complete.
�.�.r��.��,�i�-�" �? � � �l �1 % �w -�f,�k---t,�.�
'Signafure Street Aaaress � ity, Sta:e ana Zip Coae
h��
` 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 � y 5� � Ty,
Total Land �p_ �p _��
Residential Improvements
JUPJ %%�� i979 owe��in9
Garage
����rtic.�e4i(�ti
Other Improvements AUDITOR
Tr mprovements - Line (6) plus (7) equals (8)
I�uy certify the above is true. correct. and complete.
Signa:ure ol asuswr
Approved: ' �,¢clll��-l-u�
True Cash
Value
(�) y,o
(2)
(3) � / o
(q� � ��s--�O--
cs> �-°'a"
Assessed
Valuation
� o 0
300
• _ �,' '�
r ►
�7�
($) �-Q-�'�
Homestead
Valuation
�a-o 0
��!
i � Z [1 ��G�yGLfG�fG�GfS�
a�- �- � -� %
�a;e
Date: l - �-79