Fill - Free fillable PLEASEPRINTORTYPE. HOOSIER HOMESTEAD AWARD APPLICATION Farmmustcurrentlybeatlea sttwenty (20)acres.Ifthefar (State of Indiana) PDF form

***************PLEASESEEREVERSESIDE***************



INDIANASTATEDEPARTMENTOFAGRICULTURE

OneNorthCapitolAvenue,Suite600

Indianapolis,IN46204

Telephone:(317)232‐8770

Fax:(317)232‐1362

www.IN.gov/isda



PLEASEPRINTORTYPE.



QualificationsfortheAward:

Farmmustcurrentlybeatlea sttwenty (20)acres.Ifthefar mislessthantwenty(20)acresthefarmhastogr ossatleas t$1000ayear.

*Iflessthantwenty(20)acresoforiginalacquisitionareretained,pleaseprovidedocumentationoftheretainedacres’annualfarmincome.

ThefollowingstatementwillappearonyourHoosierHomesteadCertificate:



Letitberecognizedandcelebratedthatthe_____________________________________________________Family

(Insertdesiredfamilyname.)

hasownedthis________________________________________Countyfarmsince__________________________.

(Insertcountywherefarmislocated.)(Insertyearfarmwasoriginallypurchased.)



Pleaseincludewiththisapplication:

1. Acopyofallinstrumentswhichdocumenteachtransferofownership.Thecopymaybeeitherofanoriginalinstrument,

recordsmaintainedinacourthouse,orthepage(s)fromanabstractoftitlecoveringtherealestate.Thecopiesmust

demonstrateanunbrokenfamiliarchain‐of‐titlefromthedat

ethatamemberofyourfamilyoriginallyacquiredaninterestin

therealestatetothepresent.

2. Acopyofthemostrecentpropertytaxreceipts.

3. Completethetablebelowbeginningwiththeoriginalfamilyownerandcontinuingtothepresentowner(s).



**IfyourfamilyhasreceivedtheCentennialorSesquicentennialAwardbefore,youonlyneedtosupplyownershipinformationforthechangesin

ownershipthathaveoccurredsincethedatethefarmwasoriginallyawardedaHoosierHomesteadAwardtothepresentowner.

ACQUIREDFROM TRANSFERREDTO RELATIONSHIPTOPRESENTOWNER DATEACQUIRED (month,day,year)



NameofPresentowner(s)

Address(numberandstreet) SelecttheAwardyourFarmiseligiblefor:(seebelow)

CentennialSesquicentennialBicentennial

(100to149years)(150to199years)(200yearsandover)

City State ZIPCode

AddressofFarm

City State ZIPCode

County Datefarmwasoriginallyacquiredbyafamilymember

_____/______/________

Numberofacresoriginallyacquired Numberofacresoforiginalacquisitionstillretained *Numberofretainedacresactivelyfarmedbyafamilymember

**IfyourfamilyhasreceivedaHoosierHomesteadAwardalreadylist:



OriginalAwardName_________________________________Awardtype__________________________Dateoriginalawardwasreceived_____/______/________

HOOSIER HOMESTEAD AWARD APPLICATION

State form 28547 (R5 / 7-15)

INDIANA STATE DEPARTMENT OF AGRICULTURE

Reset Form

***************PLEASESEEREVERSESIDE***************



ICERTIFYTHATTHATTHEPREVIOUSINFORMATIONISTOTHEBESTOFMYKNOWLEDGETRUEANDCORRECT.

Printnameofapplicant Signatureofapplicant Date (month,day,year)

Addressofapplicant(numberandstreet) City State ZIP Code

EmailAddress Daytimetelephonenumber



ThedeadlinefortheMarchceremonyisDECEMBER1standthedeadlinefortheAugustceremonyisMAY1st.



GENERALINFORMATION:



Informationrequestedonthispage,whilenotessentialtotheHoosierHomesteadcertification,willbemost

valuabletofuturehistorians.Thequestionsbelowareofferedonlyasaguide.Pleasefeelfreetoaddany

otherdataonadditionalsheets,especiallyfamilyorpioneersstoriesconcerningfarmandsurroundingarea.



1)Fromwhomdidtheoriginalfamilypurchasethefarm?___________________________________________



2)Whatwastheoriginalperacrecostofthefarm?________________________________________________



3)Wherewasthefirstfamilyownerborn?_______________________________________________________



4)Wheredidtheoriginalfamilyownerlivepriortomovingontothefarm?_____________________________



5)Wasthisahomestead?_____________________________________________________________________



6)Didthefirstfamilyownerfarmtheland?_______________________________________________________



7)Didtheoriginalownerengageintradesoroccupationsoffthefarm?________________________________



8)Whatimprovementsweremadebytheoriginalfamilyowner?_____________________________________



9)Istheoriginalhome,oranyportionofitoroth

erbuildings,stillstandingorinuse?_____________________



10)Whenwasthepresenthomebuilt?__________________________________________________________



11)Whatarethefarm’smajorcropsorproducts?_________________________________________________



PLEASE RETURN YOUR COMPLETED APPLICATION TO:

Hoosier Homestead Award Program

Indiana State Department of Agriculture

One North Capitol Avenue, Suite 600

Indianapolis, Indiana 46204

Download
Save PDF to desktop

Email
Email completed PDF

Send for Signing
Email for others to sign

Print
Print document

NAME

PLEASEPRINTORTYPE. HOOSIER HOMESTEAD AWARD APPLICATION Farmmustcurrentlybeatlea sttwenty (20)acres.Ifthefar (State of Indiana)

View Audit Log
Print With Audit Log
Duplicate Document

Fill Online, Printable, Fillable, Blank PLEASEPRINTORTYPE. HOOSIER HOMESTEAD AWARD APPLICATION Farmmustcurrentlybeatlea sttwenty (20)acres.Ifthefar (State of Indiana) Form

Related forms

Fillable PLEASEPRINTORTYPE. HOOSIER HOMESTEAD AWARD APPLICATION Farmmustcurrentlybeatlea sttwenty (20)acres.Ifthefar (State of Indiana)

Fill Online, Printable, Fillable, Blank PLEASEPRINTORTYPE. HOOSIER HOMESTEAD AWARD APPLICATION Farmmustcurrentlybeatlea sttwenty (20)acres.Ifthefar (State of Indiana) Form

Related forms

First 20 documents completely FREE!