HomeMy WebLinkAboutHomestead_WellsFORM HC 10 1979 To Be Filed in Duplicate
Prescribed By Stale Board of Ta, Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 ZY I
SEE BACK FOR FILING INSTRUCTIONS
o ►- olla3 -oQ
® {We) ' certify that on the 1st day of
arch, 19_ZQ, I, (We) occupied as our principal place of resid ce 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 (Litt, Town, Township):
Parcel Number
If buying on contract: Owners name Ifee 9np1e O.ne0
or legal description shown on tax statement:
'r/Via% /0 -3
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.
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
Value
Land not exceeding 1 (one) acre
im la
surrounding residenti
(1)
Other Land A e � �
(2) 0
Total Land 51979 (3) ° 31 O
Residential Improvements ��N 1 Dwelling (4) 11370
_
TOR R Garage (5)
AUDI Total (6) !/ 370
Other Improvements (7) O
Tr" Improvements - Line (6) plus (7) equals (8) (8) /23� O
I *-by certify the ve is true. correct. and complete.
Signature Of ASSessOr
A p ACTION BY AUDITOR -
App
Assessed Homestead
Valuation Valuation
s'seo
Date:
RATE FoR.Mns.,tr,WO MEASURER POLY 79-IA
.APPROVED nYSTATL.'NARDIF MYYR4\'TT.!NH rtramafD MY um DEPARTMENT OF LOCAL GOVERNMENT PTANCE n'VI.1-$24.1
Gibson County Auditor
701 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
' PRINCETON IN 47670 Individuals and married couples are limited to one homestead saandani deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than net for homestead fraud.homestead 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 meene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filimg.'Htis information will he kept confidential and do only he arrested by authorised county officials.The Department of
Local Government rinavcc will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Wells, Gordon R
R1 Box 177
8556 —
Oakland City IN 47660
Gordon R Wells
8843E 550 S State Parcel Number Legal Description
Oakland City IN 47660-8580
III nI I n I I I I III III nn I n I I I I I I 26-20-10-100-001.123-001 001-01123-00 PT NW 10-3-9 35.00 AC
n
I tat t t tat .1 11 T t 11 t u f r et
ie
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PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
GoK410 Ai e_ we [.L_s
g Address(number and street,city,state,and ZIP code) _ — - - — _O Same as property addr ss
Yy3 r- cs 0 s opc k'f,fr.NIC1fyr,J
Spouse First Middle Last
Mailing Address(Number and street city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sew
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 1 Signature Date
Spouse Signature Date Telephone
( )
PART 4:ADDITIONAL INFORMATION
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