Homestead_Siekman (2) • SIVVE FORM'a de/YPo TRFASUIER FORM 71-IA
APPROVE°BY STATE MsARDOFACCOlTS.9w PRIMPDBY Till DEPARTMENT Of LOCALCA\2RNMIAT FINANCE IC 4.I.1-Z-II
Gibson County Auditor
1171 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
41 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 1344-2000 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifyine 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 Depannient of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
4 PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Siekman, Darrel R Iceeir
- R3 tax 209
Oakland City N 47660 O
207
59995t• Iy,z0O
an
Darrel R/Me Siekman art/[t.al 4b C i77 4-N'
Oakland City IN 47660-7816 State Parcel Number Legal Description 10660
IsIttIIttt ItIIrttIIttIItt tlt itlit tlttrt11t 11t r1t 1tt1t 1ttitRtil
0-26-21-30-40\0-00000.943-001 001-00943-00 PT NW SE 30-3-810 AC
•
•• PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
DPr RRcL. RR� Sr�EKM� r1
.tg Address cnumbei and iveet:city,state,lend ZIP code]- -- — _ _ _-_ _ --- u-Same as property nudtu.,- - - —•' —. _ _. —_-_
0999 3 - 12-oo E I OA-KL ITh c irk, 4t /7 60
Spouse First Middle c. Last
ChtRV — L ;,vd 1gK�/ ,r
Mailing Address(Number and street,city,state,and ZIP code) • e as property address
1 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 Sir. // Date/�
PART 4:ADDITIONAL INFORMATION
a%r
FORM HC 10 1979 - To Be Filed in Duplicate
Prescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19Z�?—
6LL bAUK F'UH HLINU IN61 HUU I TUNS _ p0 l - DO qy ,5- Ofl
(Wei °� AQ Czf&fi-fl'Z certify that on the 1st day of
arch, 192 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
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in�/`i�o✓7�_ County LLpp 2�1LLc�t- Township
Taxing District (Citq, T.&", Township):
Parcel Number or legal description shown on tax statement:
If buying on contract: Owners
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
I hereby certify the above statement is true, correct and complete.
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
U 111
Total LanQ�
ResidentiallZ mprovements
,p Dw Iling
JUPa t� , 79
Ga age
//►► Total
Other Improve�ents r
i✓✓/�11 pITO0R
Tntgl Improvement Line (6) its (7) equals (8)
I®sby certify the above is true. correct. and complete.
of Assessor
True Cash
Value
(1) Soo
(2) / -j--/0 0
(3) c7 O b O
(4) a. 01 & 0
(s)
(6) mil` Z7 1 &0
(7) 1/ ( 0
(g) A 05 -7 0
- ACTION BY AUDITOR -
Assessed
Valuation
Homestead
Valuation
iii •,..
Date: !! /