Homestead_Whitten STALE FORM R:1,1M TRsAstnRroRM 75-IA
APPROVED BY ATOL BOROOF ACfLMC 9w PALSCRIBm BY Sr DEPARTMENT OF LOCAL GOVVILNMFAT FINANCE IC. .1-r-41
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individual.. and married couple:are limited to one homestead standard deduction.As the receipt of this deduction becomes
• moor beneficial.there is more incentive than mer for homestead fraud Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the hanestead standard deduction to verify that they are eligible to teethe the
benefit and to provide additional identifying information necesury to allow county govemmenl to better monitor homestead
filings.This information will be kepi confidential and can only be aeceAsed by authorized county officials.The Depanment 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 Propert•Address
Whitten, Charles K/Lisa D
RI Box 176 ill r
Fort Branch IN 47648
��,,ff 11..
7952 '`/`;\
Charles K/Lisa D Whitten
R1 Box 176 State Parcel Number Legal Description
Fort Branch IN 47648-8003
II III I II I I III II I I I III I I I 26-19-19-203-001.238-026 INDIAN HILLS 31 PT NE 19 3 10.195
1 11 111 1 111 I1 11 1 11 1 III II tl 1 11 III AC D-27
- PART 2:TAXPAYER INFORMATION -
Owner I1 First II Middle Last
�Lc�rit_.5 �e.h rte_14\ e1,1 1. 1-le V_1 _ _
•ilmg Address(number and street.city,state,and ZIP code _ - - — e as property address L R li j3 e 4 1 I R're r-a )
2 (4 780 r >L 13re, nc1, N y71oy7
.
Spouse First Middle / Last
L) 5C. NG1,) n La) ; 7 it { ) Add 1
Mailing Address(Number and street,city,state.and ZIP code) �-6fne as property address Liu e t.0 E 9!1 Ad reS3/
ay 14, S. 780 S . �v-rT /3ra cA ! T„0 LI 76 gel?
I
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 J
•
—Pic (A6n0r nr c/res5 / 5 be(6use_ z S//
J
�..,,au
a�' g CLAIM FOR HOMESTEAD PROPERTY TAX
;'�� CREDIT/STANDARD DEDUCTION
:�.,� � State form Sa73 (R2 / 5-92)
�aia
INSTRUCTIONS: See reverse side for liling insfructians.
FORM
HC10
YEAR
tlWe) _��2%(-�'��O ��/�'/ /��% certify�(ha�n th�'15 -tlay o�f Ma�r�79_
�) occupied a5 our principal place of residence the following described real property for which a Homestead Prope�tFda GeQti is,�@by claimed:
�r u
�J I(We) owned ❑ Are buying under contract
❑ Have a beneficial interest in ihe entity ihai is liable for the property taxes on ihe property and that owns Ihe pr�(i2rty or is buf ing�,der a,�
CONTRACTRECORDED
It buying on contract, Fee Simple ownefs name
Recortler's oHice where contract is recorded
Record number Page
' � PROPERTY DESCRIPTION
Counry , TownShip / Taxing di5trict (ary%. �n, town5hip) /
� �' z`Y! /I/� D.✓ " GC i✓ / o nl a�d rl d' �t- � -
Parcel number Legal description _
/' � —
I1 any ponion of the resitlential swcmre or che land not exceedinq one (7 � acre that immediatety surrountls that swaure is used to produce ifxome, desuibe the use and portion
oi Ne property u;ilized to produce income.
�Ji �i[r�
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not ezceeding t(one) acre immediately
surrounding residential improvements. (�)
Oiherland (p)
I
7otal land (line 7 plus line 2� (3)
Dwelling (4)
Residential improvements ..
Garage (5)
Oiher improvements (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p6s line 7) (g)
I hereby certify the above is tme, corr , and SignaWre of Assessor Date signed
rnmplete.
:ryirg action - Signature oi Audiror Date signe�
% 1 — �
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