Homestead_VincentFORM HC 10 1979
Prescribed By State Board or 7a. Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 80 /
lJa„�, Ef- FOR FILING INSTRUCTIONS 0��_oloa� pO
I, (We) °�4� v r� - -f d�� 7" certify that on the 1st day of
®'arch, 19 —��I, ( ) occupied as our principal place of residence the following described real property for
vhich a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract.
❑ have a beneficial in ere t in the taxpayer
Property Description in County Township
Taxing District. (city, Town—, Township):
Parcel Number or legal description shown on tax statement:
OX- . i ✓E '% 20 - -.-? - 9 f1Q e-K�
If buying on contract: Owners name Pee simple owner)
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.
r�
Street Address
and
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 -
True Cash
Assessed Homestead
Value
Valuation Valuation
Land not exceeding 1 (one) acre immedia e
surrounding residential im
(1)
moo
17o 0
Other Land FATLED
(2)
176540
4960"
Total Land
13 1980
(3)
�/ K-0
)oogo�
MAR
Residential Improvements
(4)
30 0 0
Dwelling
��arage
151
Its
AUDITOR Total
(6)
3 0 0 0
lrF3o �BE�
Other Improvements
(y)
/0 `10 °
Total Improvements - Line (6) plus (7) equals (8)
(8)
13y- o 0
I ` Eby certify the above is true. correct. and complete.
Sigrature'ol Assessor
Dole
ACTION
BY AUDITOR
-
��
Approved: L�
Date:,3)"� 3
STATE FORM 53569(R31609) TREASURER FORM TS-IAI
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE 106-1.I-22-S.I
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
deduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
•auses higher tax bills for all; therefore, HEA 1344-2099 requires taxpayers who receive the homestead
standard deduction to verify that they are eligible to receive the benefit and to provide additional identifying
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 Department of Local
Government Finance will use this information to create tools that will help county officials eliminate
homestead fraud.
7 _ PART :, PR
OPERTI' INFORDIATION -
Taxpayer Name I,i Property Address State Parcel Number Leta!Description:
Vincent Georges&Sons ` R2 Box 147 26-20-30-200-001.092-001 001-01092-00 PT N 30-3-9 165.17
Farm Fort Branch IN 47648 AC D-10
Complete and return to: X
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
- PART.2:TAXPAYER INFORMATION -
Owner I First Middle Last
3Tit\1 ges P— ' G co l E 5
Mai5ng Address(number and street,city,state and ZIP code)
c6,0')? 3 r M1/ s c �! 4 , ll, Ir1- i9, v Same as property aEtlress
P:useeV 6 First ��/��Middle Last
A1a&ng Address and Steel,city.state and ZIP code) Same as property address �Ur �
CiV 'J? 5 t 6 s-b 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
- PART'4:jAUVITIONAL INFORMATION. .