HomeMy WebLinkAboutHomestead_Clements al{}t FORM:3,e.t _r+wl • TR ASLRV FOLM IS-IA
APPROVED BY ST4Tt WWII,Of'erotism mry PRr3A1Bm BY PIT DEPARTNFYT(f tfxAL CAt TR.VMFAT MP:ANCE M 6-I.1!'4.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 standard deduction.As the receipt of this deduction becomes
' more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore-
HEA 1341-2000 requires taxpayers who receive the homestead standard deduction to verify that they an eligible to receive the
yt f , benefit and to ormati additional identinid coal and ca necessana feu allow county raemmem to bever monitor homestead
ti
1 bentf.and
information will n Left coming i if and can only h.accec ed by linty gsd mm�t to better monitor to}hnnrm of
1 Local Government finance will use this information to create touts that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
APR 9 ZULU Taxpayer Name Property Address
Clements, W Edward/ Elizabeth A
R.Box 2 1
GIBBON--t.;6UNTY AUDITOR - IlaubsmdtlN47639 O -
8323
W Edward/Elizabeth A Clements
684E 1025 S State Parcel Number Legal Description
Haubstadt IN 47639-8039
1111111111 1t11rtttIItI11111,11111 (It 11111It 11111111It 1111 26-19-32-101-000.11999-024 004-00199-00 MACK CURTIS 41 r
-
Spouse First ��// j/Middle � Last
a/7-496E7-4 Mailing Address(Number and street,city,state.and ZIP code) El.- -me us property address
to 8V c/O 2,SS /7` as sn4DT1� 4/7629
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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.
IP
FOFM HC 10 1979
Prescribea By Siate BoarE of Tax Commissioners
To & Filed in Ouplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CHEDIT FOR YEAR 192�.
SEE BACK FOR FILING INSTRUCTIONS
�(We) � �% � � certify that on the 1st day of
.iarch, 19�Q, I, (We) occupied place of idence the following described real property for
which a Homestead Property Tax Credit is hereby being -c�layitned: �,�n /�j
I, (We) ❑ owned GY�o -/9 30� �Q� 6�.� �77- �
❑ are buying under contract vD �-' �/��! /�Q�
❑ have a beneficial inierest in the taxpayer
Property Description in County � Township
Taxing District fC.ityr-Tewn, Tnwnehinl•
Parcel Number
If buying on contract: Owners name �'� "mo�e ow�e�r
or legal description shown on tax statement:
�� �.� �,G-; �i
Contract recorded in Recorders Office - Record N
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:
� hereby certify the above statement is true, correct and complete
�
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 -
� � � � � True Cash
Value
Land not exceeding 1(one) acre immediately (1) ��
surrounding residential improvements"°�' 1 �9�9
Other Land
Total Land
Residential Improvements
� � �������
AUt�i��� �9
Garage
Total
Other Improvements
T'�' Improvements - Line (6) plus (7) equals (8)
I�by certity �he�above is true. correct, and complete.
Signature oi Pssessor
Approved: �-11 •
(2)
�s� �LS—o
�a � (o S3 0
(5) —
(6) �-f-3 °
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�g� �530
- ACTION BY AUDITOR -
Assessed
Valuation
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Date: !/ '" J ' / /