Homestead_Hipp (5) STATE FORat'3.'M,R_r...1 ihFASULLA FORM t3-M
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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 dedunmon becomes
_ more beneficial,there is more incentive than net-for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
® HEA 1344--3000 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receixe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing,This information will be kept confidential and can only be accessed by authorized county officials.'The Depanment of
Local Government Finance s itl use this information to create tools that will help county officiate eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Hipp, James H/ Eulah _
R2 Irost 109 A
Flaubstadt IN 47639
518
James H/ Eulah Hipp
1013E Warrenton RD
Haubstadt IN 47639-7936 State Parcel Number Leal Description
1111111111111 26-23-17-400-000.458-024 004-00458-00 PT W SE 1741017.464 AC
X
PART 2: TAXPAYER 1NFORMATION
Owner I First Middle Last
Eula, /'I. Mpg _
�g Address(number a street. ity,staid.end ZIP code) — _ — _ . Same as pmpem addres— _ —___ _ ___ __
/O/3 E. Warrenton Rd,
Spouse G3 ec e \ First Middle Last
(u// / J
Mailing Address(Number-and street,city,state,and ZIP code) 9 Same as property address
Social Security Number(last S digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
snx
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.
(Tyner I Signature ; ' / / Date
C� Telephone
S-8 io (F`a ) el?
-CllL y80- Van
Spouse Signature Date Telephone
PART 4:ADDITIONAL INFORMATION •
•
.
FOqM HC 1U 1979
P�e5Cri0eU By $tate BW�O al ia� CAmmfssianers
CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOR YEAR 19��
ia Be Filetl In UuO���ate
SEE BACK FOR FILING INSTRUCTIONS
OD� -oofs�oa
'_�(We) -� certify that on the tst day of
vtarch, 19 ( e) ccupied as our principal place of residence the following described.real property for
which a Homestead Property Tax Credit is hereby being claimed: �
1, (We) ❑ owned G�Zp-pi.3-,�� i'u�-[xx/• �� ��
❑ are buying under contract
❑ have a beneficial i erest in the taxpayer .
Property Description in o � County Township
Taxing District (eR'y--��wn, Township): , ,
Parcel Number
or legal description shown on tax statement:
— S�-/ O
If buying on contract: Owners name �'� s""o1e °w"e"
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 o( the property utilized to produce income
Any o[her 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 -
Land not exceeding 1(one) acre.immediately
surrounding resideniial improvements
Other Land ���iii �
Total Land � � � �
J.�
Residential Improvements Dwelling
Jll�! � ' �e
Other Improvements � !!� Tot
/� AUDITOR
T�Improvements - Line (6) plus (�) equals (8)
�.,,.,;by certif� above is true. correct. and complete.
Signawre ot Assessor
True Cash
Value
��� S� o
(2) —
(3� s—o O
(a) /�3ia
�s� —
ce) / �3i o
(�) '_
(8) / � 3 i o
,
oz�e
����
Assessed Homestead
Valuation Valuation
- ACTION BY AUDITOR -
S =z.z — 7 9
Approved: ��=7�1 l�'O-*��/�� Date: �- �-��