HomeMy WebLinkAboutHomestead_Smith (21) SIVE Mira Y1•• 02, ■•l TREASURER FORM 711A
APPROVED BY CT\R 011ARD01-■yxRENix.!On PrfFNBED BY mr nEPARtMENT IF LOCAL GOV2ANMIN7 FINANCE M 4-I.1-_r.l
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sanda,l deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than eser for homestead fraud.Ilomestead fraud causes higher tax bills for all:therefore.
• HEA 1344--2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to receive the
benefit and to provide additional identifying infomtanon necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only he accessed by authorized county officials.The Depannlent 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
_ Smith, Mary Jean Etal
810 I:Strain
/
• Fort Branch IN 47648
7806 —
Mary Jean Smith Etal
810E Strain State Parcel Number Legal Description
Fort Branch IN 47648-1429
�r�rr��rrr�r��trl�lr��rt 111111111lrllllll�ll I'llltlllll�� 26-19-18-304-000.728-025/4e1 PT SW I&310.30 AC .
PART 2: TAXPAYER INFORMATION
Owner I First �nJ.� n a _ Middle 'z Last
Add umber and street,city,state,and ZIP code) V V� me as piopoty eddress- — — - - — — - —
Spouse First Middle Last
vs'—
Mailing Address(Number and street,city,stale,and ZIP code) ❑ Same as property address
Social Security Number(last S digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sues __-_—_'
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 I Signature Date
•
FORM HC 10 1979
RcuriEeG By Slaie BwN af Tm Commissioners
To & FiIM in WDlicate
CLAIM FOR HOMESTEAD PROPEATY T�x CREDIT FOR YEAR 19 �� �
,�C� �A�G� irai-9s� �
�SEE BACK FOR FILING INSTRUCTIONS O��' OO�ab�OO
� n
�(We)�/��` � �/ � ,���� �"� certify that on the 1st day of
arch, 19 7 I, (We) occupied as our principal pla 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 ��� County �`--� Township
Taxing District (Eitq; Town, Townsbi�{: � f �-�—
Parcel Number or legal description shown on tax statement:
� • � W �/Y / 8— � - �o , �o
If buying Ofl contract: Owners name ��ee simoie ownerl
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
�hereby certify the above statement is true, correct and complete.
a�a
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�� � ��
surrounding resident im ro me
Other Land
Total Land .1UL 31979
Residential Improvements
� Y'i /���t�
�� AUDITOR
Dwelling
Garage
Total
Other Improvements
To'-' Improvements - Line (6) plus (7) equals (8)
I�oy certify the above is true, correct. and complete.
Signature oi
Approved
True Cash
Value
(�� y0 0
(�)
(8)
�
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, �`�
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39ie
�j�Q���t��3��J 71r��i�
Assessed
Valuation
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Homestead
Valuation
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Date: