HomeMy WebLinkAboutHomestead_Siekman (5)FORM HC 10 1979
Newrilied By State Board of Tax Commissioners
To Be Fled in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 79
SEE BACK FOR FILING INSTRUCTIONS o9'- Q O a5a. -�
�(We1 =° o _ A-44 r "' �� certify that on the 1st day of
arch, 19 I, (We) occupied as o r principal place of resident th2 a 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 interes In the taxpayer
Property Description in County -115e7� Township
Taxing District (Gify, Taws, Township): 290
Parcel Number or legal description shown on tax statement:
pt 56� NEB+
If buying on contract: Owners name V- simple o..e,i
Contract recorded in Recorders Office - Record No
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
l- 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 F I L En
Total Land "
Residential Improvement 31979
True Cash
Value
(1) -:5 -oo
(2) SO
(3) .5--5,D
Dwelling (4) G-- / - /-�0
Garage
i �, Total
Other Improvements (/ AUDITOR
T�f'l Improvements - Line (6) plus (7) equals (8)
l aby certify the above is true. correct. and complete.
App
(5) / 7 0
(6) to 8 3 O
(7) i 70
(8) 7 o mo
- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
/70 /70
3330
S/G - 7
Dave
Date:
BATE I ORM.IY'IR':w'I MEASURER FORM TS-IA
.APPROVED BY STATE BOARD Of ACTVX NTC.]m PUSA1nFD BY 1111 DEPAPINTNI OWLOCAL COVER:NEFT r.AscE NOH.I-r-sI
13 ibson 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
t more beneficial,there is more incentive than ewer for homestead fraud.I lomestead fraud causes higher in 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 infumunton necessary to allow county government to better monitor homestead
filings.This information will he kepi confidential and can only he 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
_ Siekman, Gary W/Gwendolyn /
(1 2 nox7
•
Buckskin IN 47647
8814
Gary W/Gwendolyn Siekman
8437E 900 S State Parcel Number Legal Description
Buckskin IN 47647-9001
I I I t t I l t t d 111111111111111111111111,11 111111111111111111 26-20-28-200-000.952-001 001-00952-00 PT SE NE 2&39 2 AC
D-19
`X/
4 PART 2:TAXPAYER INFORMATION
Owner I First Middle P Last
€
tong (number and street,city.state,and ZIP codev) - -_ n — _...XL Same as property address - _— _- . _
I j i'/3 7 e 9 o o s 47l 7 - 900/
S.. - First Middle d ' Last
iiii
Mailine Address( "her and street.city.state,and ZIP cote Same as property address
/7/37 I 400 fei l � ('4 z-71 76 LI-7
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
I _ / 0 . %