Homestead_HancockSTAiE FORA1 A569 (IU!&10) TAEASURER FOR?I i5-IA
APPROYED BY STAiE BOARp OF ACCOU�TS, 3009 PRESCRIBFD BY i}IE DEPMTMEpT OF LOCAL GO\'Eµ,\lff\T FIA'A�'CE ICbl.l-'_'-B.I
' / � 1 , � . , 1 � , 1 � , � • '
Iudividuals and married couples are limited to one 6omestead standard deduction. As the receipt of this
��ductioo becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
�causes higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
standard deduction to verify that they are eligible to receive the benefit and to provide additional identif��ing
information necessary to allow county government to better monitor homestead filings. This information
will be kept confideutial and can onl�� be accessed by authorized couoty officials. The Department of Local
Government Finance will use this information to create tools that will help county officials eliminatc
homestead fraud.
Taaoaver \'ame
Cedrick B/ Charlo�te L Hancock
Camplete mtd return !o:
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Mativigl.tlmezs (num0er eM sueet, tiry, stx
Prooem Addresf
569 S BARN LN
PRINCETON IN 47670
$tate Partel \umber
26-11-IS-100-004.060-027
Le¢al Dacrimion:
M C ROBERTS TICHENOR RD
PHASE 16 D-17
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GIBSON COU�TY AUDITOR, 101 N MAIN PRINCETON IN 47670
°B I�� /dease soeuty in Fart a Deiow)
tactl untlerstgnetl certifies, untler penalry of perjury, that the above and foregoing intortnation is true and wnect and that he or she is eligible to receive I
homestead standard deduction on this property. Each undersigned also understands that, by claiming additional homesiead deductions unlawfully, he or
she may be liable for back taxes and substantial financial penalties.
Owner t SpnaMe j Daro Telepnma
Dale
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i��`��"" - CLA ESTEAD PROPERTY TAX
��� ° CREDIT/STANDARD DEDUCTION
_i State Form 5473 (fi2 / S92)
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INSTRUCTIONS: See reverse side for filing inshuctions.
FORM
HC10
YEAR
C FICATIO ATEMENT
I(We certity that on ihe 1st day of March, 79_
I(We) ed as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
(VJe) owned ❑ Are buying under coniract �
❑ Have a beneficial interest in the entiry that is liable for the property taxes on the property and ihat owns the property or is buying under a contract.
CONTRACTRECORDED
If buying on crontract, Fee Simple ovmets name
Recortlers office where contract is recorded Recortl number Page
PROPERTV DESCRIPTI
Counry Township Taning tlisi , t , t shipJ -
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,�SU�` -C7� f�O , ���P��, .
If any pwtion of the resitlential structure or the land not exceeding one (1) acre that immediatey surtounds ihai swcture is used to produce incom , �'rc fUA � u3iVttl poNOn ot
Ne property utilizetl to produce income. G LUUO
� GIB/�NTI' AUDITOR
PROPERTY OWNED BV CLAIMANT IN OTHER COUNTRIES '
Counry Township Counry Township
Si tur otda' n
�ereby certify the above statements are true, correct and complete.
Address(numberantl�s�eet.lcily,state,Z�eJ �� � �J��O .
R� 8 �5 n� �
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VAIUE VALUE VALUE
Land not ezceeding 7(one) acre immediately �� �
surrounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvements
Garage (5)
Other improvemenis (6) .
Total improvemenis (line 4 through line 6) (7)
Total value (line 3 plus line 7J (8)
I hereby certify Ihe above is Irue, corrett, and Signature of Assesor Date signed
complete.
Verifyi� actbn - Signature of AuAitor Date signetl
� STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of t/2 Homestead S
Valuation or 52,000
Signature of Autlitor Date signed