Homestead_Capehart N.
N-
- SIATE FORM!We et:I 4.n1 T ESSULER FORM:-IA
,APPRrREO IW crsr.en•Pn Of MrT R 11 L.Vs. PRISTIMFD BY MT DEr,VIMEYT OF LOCAL GOVERNMENT FIANCE M41.1ra.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc 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.
ar HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings This inlhrnatinn will be kepi confidential and can only he accessed by authorized county officials.The Depannrent of
Local Government Finance sv ill use this information to create tads that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Capehart, Danny R/Vanada K
• 1025 S Race ST
Princeton IN 47670
3781
Danny R/Vanada K Capehart
1025 S Race ST - State Parcel Number Legal Description
Princeton IN 47670-2728
Illiillrttltllttltttlll I IltttlttltllttltrtlllrlrltlltttI X 261z 19-201-000.346028 0,000aasoossnDDZZz
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Danny Ralph Capehart
�tg Address(number and street,city,state.and ZIP code) — -- Satre as property oldies — ---- -- --
1025 S. Race Street Princeton IN 47670-2728
Spouse First Middle Last
Vanada Kathryn Capehart
Mailing Address(Number and street,city,state,and ZIP code) ® Same as properly addrtai
1025 S Ran Street Prinr'ctnn TN 47670-7778
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.
Ow a I Signature .x Date
7
wu� Hc ia ism
Preuribe0 By SUte BoarE ol Tar Cammissioners
CLAIM FOA HOMESTEAO PROPERTY TAX CREDIT FOA YEAR 19�,�
To & FileA in OuDliwte
/
D/9- � 0 3�l 6- a�
�(We) ��}- �• ���"�-O�Q� '�-• �-�`-���0.� certify that on the 1st day of
March, 19—, I, (W occupied as our principal place�of resi ence 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
Oi ..
Property Description
Taxing District (City, Town, Township): '�
Parcel Number
It buying on contract: Owners name �'� "inp1e °'""ef�
ry ��-+-+�'-.�% Township
or legal description shown on tax statement:
i�..B• Q.d�2.. ��-z,
Contract recorded in Recorders Office - Record
If any portion of the residential structure or the land, not exceeding one (1) acre that immediateiy 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
State ana
` 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 residen�al �mprov�men s� �
Other Land
Total Lantl
Residential Improvements ��� � ' '� �9
Dwelling
�r � ����.�._, Garage
�, � / `�ti�k-ev`�"' Total
Other Improvements � AUDITOR
T� Improvements - Line (6) plus (7) equals (8)
i�aby certify the above is true. �dlrrect. and complete
X
Sigiuwee of Assessor
True Cash Assessed Homestead
Value valuation Valuation
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Date
Date: �d_L_L�
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