Homestead_Tepe (7)FORM HC 10 1979 _ To Be Filed in Duplicate
prescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 192 `
/l.tr-F^+� d-SEE BACK FOR FILING INSTRUCTIONS ✓
001- O V -00 (We) certify that on the 1st day of
4arch, 19'(We) oofupied as our principal pittfl5re of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
Xare buying under contract
❑ have a beneficial interest in the taxpayer
Property Description
Taxing District (G4y, Te+vn, Township):
Parcel Number
If buying on contract: Owners
Township
or legal description shown on tax statement:
/vcv% 31-3- k �Z
J r —_L_ ? Page
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:
ereby certify the above statement is true, correct and complete.
T,
County
Township
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 FILED
Total Land
Residential Improvements 1U 2 C 19 79 Dwelling
Garage
'Lt.2'd& Total
Other Improvements 11 AUDITOR
Te ftimprovements
11. _ray certify the
Slgnalure of Assessor /
- Line (6) plus (7) equals (8)
above is true. correct. and complete.
M
True Cash Assessed Homestead
Value Valuation Valuation
(1) S O 0
(2) 0 0
(a) 3/,2 0
(5) —
(6) 3/ Z o
(7) / 7 8 0
(8) XIQ 00
Date
Date: Z
SIME lOR4.3 W 12'/YNI MAEAAitfA!ORM 75-IA
APPRo'EB BY MATE BOARDOP.in"TR T%l.n PPug,IBn,By nir OFPARIT OF rtXAI CKATIthN1Al FINANCE re-pt-2Z4.1
Gibson County Auditor
A1 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON • t a Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
1� is more beneficial,there more incentive than e'er for homestead fraud.Ilomestead fraud causes higher tax bills for all:therefore.
.-.......1 it
HEA 1344-2009 requires taxpayers homestead receive the homestead standard deduction to verify that they are eligible to receise the
benefit and to provide additional identifying information necessary to allow counts.government to better monitor homestead
y filings This information will he kepi confidential and can only he accessed by authorized county officials.The Depannient of
V Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
APR 2 6 zui PART I: PROPERTY INFORMATION
_ Taxpayer Name Pro l er-iv Address
_ 6' Tepe, Robert/Joyce
—GIBSON CO
NT
AUpIfibN
R3 Hns 205 A
Oakland City IN 47660 i
9292 Q\
Robert/Joyce Tepe oc
12110E 1000 S State Parcel Number Legal Description
Oakland City IN 47660-7808
itirtilrt 11111 t 111111x11.11(.1111111 lilt lit 11,111iiii 1111 26-21-31-200-001.061-001 001-01061-00 PT NW 31-3-89.27 AC
D-19
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
S O b e b t c%j e 1-g-p e—
*no Address(number and street.city,state,and ZIP code) .'`t Same as property address - - '- - -
/Z//0t , 0005, OQkf4,yCl (; (y , Ind 0-11. CL c/ 766o
Spouse First Middle Last
• To tic e /`I a-a r' e repo
Meiling Add (Number and street,city.state,and ZIP code) �'I Same as propeny dress
/2/ /CIE /0005. O�klatid 6; Iht1I0,1ia 97660
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
PART 4:ADDITIONAL INFORMATION
ill